| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $281.86 | $281.86 | $281.86 | |
Aetna
| Professional | $281.86 | $307.45 | $307.45 | |
Cigna
| Facility | $345.23 | $529.72 | $650.73 | |
Cigna
| Professional | $176.32 | $364.39 | $1,412.55 | |
United
| Professional | $150.46 | $257.31 | $525.63 |