| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $610.95 | $610.95 | $775.40 | |
Cigna
| Facility | $1,149.77 | $1,149.77 | $1,149.77 | |
Cigna
| Professional | $839.33 | $839.33 | $1,149.77 | |
United
| Professional | $613.60 | $740.61 | $1,115.63 |