| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $77.62 | $77.62 | $616.60 | |
Aetna
| Professional | $575.44 | $602.56 | $616.60 | |
Cigna
| Facility | $616.60 | $1,148.15 | $1,148.15 | |
Cigna
| Professional | $616.60 | $616.60 | $3,235.94 | |
United
| Professional | $125.89 | $724.44 | $724.44 |