| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,122.91 | $1,122.91 | $1,122.91 | |
Aetna
| Professional | $392.08 | $392.08 | $392.09 | |
Cigna
| Professional | $392.09 | $392.09 | $401.08 | |
United
| Professional | $156.84 | $392.09 | $462.42 |