| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $828.00 | $828.00 | $828.00 | |
Aetna
| Professional | $568.79 | $568.79 | $568.79 | |
Cigna
| Professional | $827.24 | $827.24 | $1,034.05 | |
United
| Professional | $252.00 | $302.39 | $720.00 |