| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $22.12 | $86.54 | $1,299.96 | |
Aetna
| Professional | $50.31 | $78.01 | $125.27 | |
Cigna
| Facility | $71.34 | $71.34 | $71.34 | |
Cigna
| Professional | $56.94 | $93.67 | $178.18 | |
United
| Facility | $440.00 | $440.00 | $440.00 | |
United
| Professional | $59.96 | $91.41 | $203.81 |