| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $241.92 | $241.92 | $668.16 | |
Aetna
| Professional | $115.20 | $241.92 | $241.92 | |
Cigna
| Facility | $249.60 | $289.54 | $574.08 | |
United
| Facility | $172.80 | $172.80 | $172.80 | |
United
| Professional | $80.64 | $115.20 | $192.00 |