| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $302.00 | $302.00 | $302.00 | |
Aetna
| Professional | $173.78 | $208.93 | $776.25 | |
Cigna
| Professional | $173.78 | $302.00 | $371.54 | |
United
| Professional | $107.15 | $154.88 | $575.44 |