| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $739.40 | $739.40 | $739.40 | |
Aetna
| Professional | $713.30 | $739.40 | $739.40 | |
Cigna
| Facility | $739.40 | $739.40 | $739.40 | |
Cigna
| Professional | $739.40 | $739.40 | $739.40 | |
United
| Professional | $57.20 | $85.80 | $150.15 |