| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $713.50 | $713.50 | $713.50 | |
Aetna
| Professional | $713.50 | $713.50 | $856.20 | |
Cigna
| Facility | $713.50 | $713.50 | $713.50 | |
Cigna
| Professional | $713.50 | $713.50 | $713.50 | |
United
| Facility | $975.26 | $975.26 | $1,189.82 | |
United
| Professional | $620.75 | $713.50 | $713.50 |