| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $103.50 | $177.80 | $1,400.00 | |
Aetna
| Professional | $103.50 | $168.43 | $201.43 | |
Cigna
| Facility | $191.97 | $191.97 | $191.97 | |
Cigna
| Professional | $107.52 | $194.68 | $425.18 | |
United
| Professional | $141.68 | $205.27 | $335.27 |