| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $735.05 | $735.05 | $735.05 | |
Aetna
| Professional | $735.05 | $735.05 | $882.05 | |
Cigna
| Facility | $735.05 | $735.05 | $735.05 | |
Cigna
| Professional | $735.05 | $735.05 | $735.05 | |
United
| Professional | $624.79 | $735.05 | $735.05 |