| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $731.01 | $731.01 | $731.01 | |
Aetna
| Professional | $731.01 | $731.01 | $793.35 | |
Cigna
| Facility | $876.07 | $876.07 | $876.07 | |
Cigna
| Professional | $876.07 | $876.07 | $876.07 | |
United
| Professional | $845.27 | $886.96 | $1,053.27 |