| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $587.63 | $624.36 | $624.36 | |
Cigna
| Facility | $624.36 | $624.36 | $624.36 | |
Cigna
| Professional | $624.36 | $624.36 | $624.36 | |
United
| Professional | $587.63 | $612.11 | $992.10 |