| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $141.25 | $141.25 | $141.25 | |
Aetna
| Professional | $173.78 | $245.47 | $316.23 | |
Cigna
| Facility | $537.03 | $537.03 | $537.03 | |
Cigna
| Professional | $151.36 | $1,621.81 | $1,621.81 | |
United
| Professional | $165.96 | $239.88 | $389.05 |