| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $912.01 | $912.01 | $954.99 | |
Cigna
| Facility | $912.01 | $912.01 | $912.01 | |
Cigna
| Professional | $912.01 | $912.01 | $912.01 | |
United
| Professional | $125.89 | $1,348.96 | $1,659.59 |