| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $674.80 | $1,248.68 | $2,784.04 | |
Aetna
| Professional | $650.99 | $674.81 | $674.81 | |
Cigna
| Facility | $674.81 | $674.81 | $674.81 | |
Cigna
| Professional | $674.81 | $674.81 | $674.81 | |
United
| Professional | $630.48 | $661.57 | $661.57 |