| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $128.82 | $128.82 | $128.82 | |
Aetna
| Professional | $1,288.25 | $1,348.96 | $1,621.81 | |
Cigna
| Professional | $1,380.38 | $1,380.38 | $1,380.38 | |
United
| Professional | $125.89 | $1,348.96 | $1,348.96 |