| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $489.78 | $489.78 | $512.86 | |
Cigna
| Facility | $489.78 | $489.78 | $489.78 | |
Cigna
| Professional | $489.78 | $489.78 | $489.78 | |
United
| Professional | $125.89 | $776.25 | $977.24 |