| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $676.08 | $676.08 | $676.08 | |
Aetna
| Professional | $257.04 | $257.04 | $275.42 | |
Cigna
| Facility | $263.03 | $263.03 | $263.03 | |
Cigna
| Professional | $263.03 | $263.03 | $263.03 | |
United
| Professional | $263.03 | $275.42 | $295.12 |