| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $251.19 | $251.19 | $263.03 | |
Cigna
| Facility | $257.04 | $257.04 | $257.04 | |
Cigna
| Professional | $251.19 | $251.19 | $251.19 | |
United
| Professional | $251.19 | $269.15 | $288.40 |