| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $412.43 | $412.43 | $412.43 | |
Aetna
| Professional | $280.86 | $412.43 | $416.40 | |
Cigna
| Facility | $64.00 | $64.00 | $64.00 | |
Cigna
| Professional | $73.18 | $73.18 | $73.18 | |
United
| Professional | $174.73 | $174.73 | $174.73 |