| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $555.20 | $555.20 | $555.20 | |
Aetna
| Professional | $555.20 | $555.20 | $666.24 | |
Cigna
| Facility | $555.20 | $555.20 | $555.20 | |
Cigna
| Professional | $555.20 | $555.20 | $555.20 | |
United
| Professional | $499.68 | $555.20 | $566.29 |