| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $131.83 | $131.83 | $131.83 | |
Aetna
| Professional | $67.61 | $70.79 | $85.11 | |
Cigna
| Facility | $56.23 | $56.23 | $56.23 | |
Cigna
| Professional | $131.83 | $131.83 | $165.96 | |
United
| Professional | $33.11 | $51.29 | $128.82 |