| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $208.93 | $208.93 | $208.93 | |
Aetna
| Professional | $173.78 | $208.93 | $245.47 | |
Cigna
| Professional | $288.40 | $288.40 | $288.40 | |
United
| Professional | $83.18 | $114.82 | $245.47 |