| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $381.23 | $381.23 | $381.23 | |
Aetna
| Professional | $381.23 | $381.23 | $381.23 | |
Cigna
| Facility | $85.00 | $381.23 | $381.23 | |
Cigna
| Professional | $120.65 | $381.23 | $381.23 | |
United
| Professional | $390.00 | $390.00 | $564.84 |