| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,499.67 | $1,499.67 | $1,499.67 | |
Aetna
| Professional | $795.33 | $1,499.67 | $1,499.67 | |
Cigna
| Facility | $109.87 | $109.87 | $109.87 | |
Cigna
| Professional | $93.39 | $109.87 | $147.10 | |
United
| Professional | $54.94 | $94.93 | $784.20 |