| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $616.60 | $616.60 | $616.60 | |
Aetna
| Professional | $208.93 | $239.88 | $389.05 | |
Cigna
| Professional | $263.03 | $263.03 | $263.03 | |
United
| Professional | $302.00 | $302.00 | $354.81 |