| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $726.45 | $726.45 | $897.15 | |
Cigna
| Facility | $1,184.20 | $1,184.20 | $1,184.20 | |
Cigna
| Professional | $864.47 | $864.47 | $1,184.20 | |
United
| Professional | $729.60 | $880.62 | $1,326.54 |