| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $1,902.62 | $1,902.62 | $1,902.62 | |
Cigna
| Facility | $1,902.62 | $1,902.62 | $1,902.62 | |
Cigna
| Professional | $1,902.62 | $1,902.62 | $1,902.62 | |
United
| Professional | $1,902.62 | $1,997.75 | $2,853.93 |