| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $1,969.89 | $1,969.89 | $1,969.89 | |
Cigna
| Facility | $1,969.89 | $1,969.89 | $1,969.89 | |
Cigna
| Professional | $1,969.89 | $1,969.89 | $1,969.89 | |
United
| Professional | $1,969.89 | $1,969.89 | $3,192.76 |