| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $915.09 | $915.09 | $915.09 | |
Aetna
| Professional | $915.09 | $915.09 | $1,006.60 | |
Cigna
| Facility | $915.09 | $915.09 | $915.09 | |
Cigna
| Professional | $915.09 | $915.09 | $915.09 | |
United
| Professional | $796.13 | $915.09 | $915.09 |