| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $289.43 | $769.31 | $3,140.00 | |
Aetna
| Professional | $112.62 | $196.50 | $196.50 | |
Cigna
| Professional | $118.51 | $196.66 | $296.19 | |
United
| Professional | $153.59 | $223.01 | $490.62 |