| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $575.44 | $575.44 | $575.44 | |
Aetna
| Professional | $223.87 | $316.23 | $549.54 | |
Cigna
| Professional | $223.87 | $223.87 | $223.87 | |
United
| Professional | $213.80 | $223.87 | $338.84 |