| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $141.25 | $141.25 | $141.25 | |
Aetna
| Professional | $107.15 | $151.36 | $165.96 | |
Cigna
| Facility | $257.04 | $257.04 | $257.04 | |
Cigna
| Professional | $741.31 | $741.31 | $741.31 | |
United
| Professional | $117.49 | $177.83 | $269.15 |