| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $378.94 | $378.94 | $378.94 | |
Aetna
| Professional | $220.77 | $220.77 | $273.49 | |
Cigna
| Professional | $167.65 | $185.70 | $491.66 | |
United
| Professional | $138.38 | $197.71 | $724.92 |