| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $1,590.54 | $1,590.54 | $1,590.54 | |
Cigna
| Facility | $1,590.54 | $1,590.54 | $1,590.54 | |
Cigna
| Professional | $1,590.54 | $1,590.54 | $1,590.54 | |
United
| Professional | $1,590.54 | $1,590.54 | $2,577.92 |