| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $2,784.38 | $2,784.38 | $2,784.38 | |
Cigna
| Facility | $2,784.38 | $2,784.38 | $2,784.38 | |
Cigna
| Professional | $2,784.38 | $2,784.38 | $2,784.38 | |
United
| Professional | $2,784.38 | $2,784.38 | $4,512.87 |