| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $615.26 | $615.26 | $615.26 | |
Aetna
| Professional | $579.07 | $600.79 | $615.26 | |
Cigna
| Facility | $615.26 | $615.26 | $615.26 | |
Cigna
| Professional | $615.26 | $615.26 | $615.26 | |
United
| Professional | $651.46 | $723.84 | $745.56 |