| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $245.47 | $245.47 | $245.47 | |
Aetna
| Professional | $245.47 | $245.47 | $407.38 | |
Cigna
| Facility | $407.38 | $407.38 | $407.38 | |
Cigna
| Professional | $323.59 | $323.59 | $323.59 | |
United
| Facility | $851.14 | $851.14 | $851.14 | |
United
| Professional | $707.95 | $707.95 | $707.95 |