| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,210.68 | $1,210.68 | $1,210.68 | |
Aetna
| Professional | $122.50 | $272.85 | $272.85 | |
Cigna
| Facility | $250.00 | $365.00 | $677.00 | |
Cigna
| Professional | $150.00 | $363.63 | $454.54 | |
United
| Professional | $452.75 | $452.75 | $452.75 |