| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $655.61 | $655.61 | $4,846.00 | |
Aetna
| Professional | $655.61 | $655.61 | $1,383.34 | |
Cigna
| Facility | $881.00 | $881.00 | $881.00 | |
United
| Facility | $2,400.00 | $3,870.00 | $5,490.00 |