| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $95.39 | $95.39 | $95.39 | |
Aetna
| Professional | $64.53 | $95.39 | $104.97 | |
Cigna
| Professional | $785.24 | $785.24 | $785.24 | |
United
| Professional | $1,294.79 | $1,438.66 | $1,467.43 |