| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $739.40 | $739.40 | $739.40 | |
Aetna
| Professional | $722.00 | $739.40 | $739.40 | |
BCBS
| Facility | $751.26 | $751.26 | $751.26 | |
BCBS
| Professional | $751.26 | $751.26 | $751.26 | |
Cigna
| Facility | $612.00 | $739.40 | $739.40 | |
Cigna
| Professional | $739.40 | $739.40 | $739.40 | |
United
| Professional | $57.20 | $85.80 | $128.96 |