| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $262.77 | $360.25 | $424.93 | |
Cigna
| Facility | $128.00 | $128.00 | $128.00 | |
Cigna
| Professional | $108.80 | $128.00 | $128.00 | |
United
| Professional | $305.79 | $421.85 | $703.40 |