| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $114.82 | $354.81 | $389.05 | |
Cigna
| Facility | $407.38 | $407.38 | $407.38 | |
Cigna
| Professional | $407.38 | $407.38 | $407.38 | |
United
| Professional | $125.89 | $354.81 | $478.63 |