| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $776.25 | $776.25 | $891.25 | |
Aetna
| Professional | $741.31 | $741.31 | $891.25 | |
Cigna
| Facility | $741.31 | $741.31 | $741.31 | |
Cigna
| Professional | $741.31 | $741.31 | $741.31 | |
United
| Professional | $125.89 | $933.25 | $1,862.09 |