| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $987.94 | $987.94 | $987.94 | |
Cigna
| Facility | $987.94 | $987.94 | $987.94 | |
Cigna
| Professional | $475.33 | $475.33 | $475.33 | |
HMSA
| Professional | $718.73 | $718.73 | $718.73 | |
United
| Professional | $436.19 | $436.19 | $699.02 |