| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $870.96 | $870.96 | $870.96 | |
Aetna
| Professional | $691.83 | $812.83 | $933.25 | |
Cigna
| Professional | $1,096.48 | $1,096.48 | $1,096.48 | |
United
| Professional | $676.08 | $1,122.02 | $1,995.26 |