| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $1,640.93 | $1,640.93 | $1,640.93 | |
Cigna
| Facility | $1,640.93 | $1,640.93 | $1,640.93 | |
Cigna
| Professional | $1,640.93 | $1,640.93 | $1,640.93 | |
United
| Professional | $1,283.57 | $1,640.93 | $3,610.05 |