| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $690.17 | $690.17 | $690.17 | |
Aetna
| Professional | $663.63 | $663.63 | $690.17 | |
BCBS
| Facility | $0.02 | $0.02 | $35.20 | |
Cigna
| Facility | $626.05 | $663.63 | $663.63 | |
Cigna
| Professional | $663.63 | $663.63 | $663.63 | |
United
| Professional | $663.63 | $663.63 | $663.63 |