| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $903.21 | $903.21 | $903.21 | |
Aetna
| Professional | $871.33 | $903.21 | $903.21 | |
Cigna
| Facility | $903.21 | $903.21 | $903.21 | |
Cigna
| Professional | $903.21 | $903.21 | $903.21 | |
United
| Professional | $843.88 | $885.50 | $885.50 |