| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $260.20 | $260.20 | $260.20 | |
Aetna
| Professional | $251.02 | $260.20 | $260.20 | |
Cigna
| Facility | $260.20 | $260.20 | $260.20 | |
Cigna
| Professional | $260.20 | $260.20 | $260.20 | |
United
| Professional | $255.10 | $255.10 | $290.81 |