| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $616.60 | $616.60 | $616.60 | |
Aetna
| Professional | $575.44 | $602.56 | $724.44 | |
Cigna
| Facility | $616.60 | $616.60 | $1,071.52 | |
Cigna
| Professional | $616.60 | $616.60 | $2,818.38 | |
United
| Facility | $660.69 | $660.69 | $660.69 | |
United
| Professional | $660.69 | $676.08 | $724.44 |