| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $194.98 | $194.98 | $194.98 | |
Aetna
| Professional | $112.20 | $141.25 | $501.19 | |
Cigna
| Facility | $109.65 | $109.65 | $109.65 | |
Cigna
| Professional | $112.20 | $112.20 | $112.20 | |
United
| Professional | $70.79 | $102.33 | $371.54 |