| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,468.89 | $1,468.89 | $1,468.89 | |
Aetna
| Professional | $779.12 | $1,468.89 | $1,468.89 | |
Cigna
| Facility | $107.63 | $107.63 | $107.63 | |
Cigna
| Professional | $91.49 | $107.63 | $144.13 | |
United
| Professional | $53.82 | $92.99 | $768.18 |