| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $794.33 | $794.33 | $794.33 | |
Aetna
| Professional | $794.33 | $794.33 | $794.33 | |
Cigna
| Facility | $977.24 | $977.24 | $977.24 | |
Cigna
| Professional | $269.15 | $269.15 | $269.15 | |
United
| Facility | $954.99 | $1,230.27 | $2,344.23 |