| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $52.48 | $104.71 | $1,513.56 | |
Aetna
| Professional | $56.23 | $104.71 | $257.04 | |
Aetna
| Professional | 50 | $89.13 | $257.04 | $323.59 |
Cigna
| Professional | $52.48 | $97.72 | $169.82 | |
United
| Facility | $144.54 | $144.54 | $501.19 | |
United
| Professional | $54.95 | $91.20 | $162.18 |