| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $430.09 | $430.09 | $430.09 | |
Aetna
| Professional | $430.09 | $430.09 | $430.09 | |
Cigna
| Professional | $457.73 | $457.73 | $457.73 | |
United
| Professional | $492.27 | $518.17 | $518.17 |