| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $740.02 | $740.02 | $848.77 | |
Cigna
| Facility | $1,191.78 | $1,191.78 | $1,191.78 | |
Cigna
| Professional | $870.00 | $870.00 | $1,191.78 | |
United
| Professional | $680.25 | $897.07 | $1,351.31 |