| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $640.73 | $640.73 | $640.73 | |
Aetna
| Professional | $640.73 | $640.73 | $640.73 | |
Cigna
| Professional | $736.38 | $736.38 | $920.47 | |
United
| Professional | $269.11 | $269.11 | $640.73 |