| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $407.38 | $407.38 | $407.38 | |
Aetna
| Professional | $281.84 | $295.12 | $354.81 | |
Cigna
| Professional | $407.38 | $407.38 | $512.86 | |
United
| Professional | $125.89 | $213.80 | $537.03 |