| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $422.89 | $422.89 | $495.52 | |
Cigna
| Facility | $419.86 | $419.86 | $419.86 | |
Cigna
| Professional | $422.89 | $422.89 | $422.89 | |
United
| Professional | $422.89 | $448.26 | $703.90 |