| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $171.00 | $171.00 | $171.00 | |
Cigna
| Facility | $223.70 | $223.70 | $223.70 | |
Cigna
| Professional | $935.47 | $935.47 | $935.47 | |
United
| Professional | $61.10 | $190.24 | $344.44 |