| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $626.33 | $626.33 | $626.33 | |
Aetna
| Professional | $243.71 | $243.71 | $568.41 | |
Cigna
| Facility | $252.06 | $252.06 | $252.06 | |
Cigna
| Professional | $243.71 | $243.71 | $243.71 | |
United
| Professional | $243.71 | $258.33 | $365.57 |