| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $416.44 | $467.92 | $467.92 | |
Cigna
| Facility | $567.88 | $567.88 | $567.88 | |
Cigna
| Professional | $414.55 | $414.55 | $414.55 | |
United
| Professional | $375.63 | $567.23 | $854.43 |