| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $4,220.17 | $4,220.17 | $4,483.93 | |
Cigna
| Facility | $4,483.93 | $4,483.93 | $4,483.93 | |
Cigna
| Professional | $4,483.93 | $4,483.93 | $4,483.93 | |
United
| Professional | $5,275.21 | $5,275.21 | $5,275.21 |