| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $660.69 | $660.69 | $660.69 | |
Aetna
| Professional | $457.09 | $478.63 | $1,737.80 | |
Cigna
| Facility | $380.19 | $380.19 | $380.19 | |
Cigna
| Professional | $389.05 | $660.69 | $1,071.52 | |
United
| Professional | $190.55 | $354.81 | $870.96 |