| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $553.94 | $553.94 | $553.94 | |
Cigna
| Facility | $553.94 | $553.94 | $553.94 | |
Cigna
| Professional | $553.94 | $553.94 | $553.94 | |
United
| Professional | $553.94 | $553.94 | $1,374.06 |