| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $454.69 | $454.69 | $454.69 | |
Aetna
| Professional | $454.69 | $550.25 | $930.45 | |
Cigna
| Professional | $115.02 | $122.21 | $194.10 | |
United
| Professional | $753.55 | $987.43 | $1,346.75 |