| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $194.98 | $194.98 | $32,359.37 | |
Aetna
| Professional | $75.86 | $75.86 | $208.93 | |
Cigna
| Facility | $75.86 | $75.86 | $75.86 | |
Cigna
| Professional | $75.86 | $75.86 | $75.86 | |
United
| Professional | $75.86 | $79.43 | $87.10 |