| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $354.81 | $354.81 | $371.54 | |
Cigna
| Facility | $354.81 | $354.81 | $354.81 | |
Cigna
| Professional | $354.81 | $354.81 | $354.81 | |
United
| Professional | $354.81 | $380.19 | $398.11 |