| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $199.53 | $199.53 | $199.53 | |
Aetna
| Professional | $134.90 | $144.54 | $173.78 | |
Cigna
| Professional | $199.53 | $199.53 | $251.19 | |
United
| Professional | $60.26 | $104.71 | $257.04 |