| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,496.79 | $1,496.79 | $1,496.79 | |
Aetna
| Professional | $1,443.96 | $1,496.79 | $1,496.79 | |
Cigna
| Facility | $482.77 | $482.77 | $864.65 | |
Cigna
| Professional | $410.35 | $410.35 | $1,002.38 | |
United
| Professional | $256.95 | $433.70 | $598.70 |