| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,334.85 | $4,334.85 | $4,334.85 | |
Aetna
| Professional | $79.86 | $79.86 | $87.85 | |
Cigna
| Facility | $78.50 | $78.50 | $78.50 | |
Cigna
| Professional | $79.86 | $79.86 | $79.86 | |
United
| Professional | $79.86 | $88.64 | $131.43 |