| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $776.84 | $776.84 | $776.84 | |
Aetna
| Professional | $749.42 | $776.84 | $776.84 | |
Cigna
| Facility | $776.84 | $776.84 | $776.84 | |
Cigna
| Professional | $776.84 | $776.84 | $776.84 | |
United
| Professional | $725.81 | $761.61 | $761.61 |