| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $411.66 | $629.54 | $8,724.66 | |
Aetna
| Professional | $160.18 | $242.85 | $329.51 | |
Aetna
| Professional | 50 | $655.27 | $655.27 | $655.27 |
Cigna
| Professional | $180.38 | $289.69 | $405.61 | |
United
| Professional | $247.50 | $376.66 | $563.53 |