| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $82.40 | $156.65 | $3,949.00 | |
Aetna
| Professional | $82.40 | $156.65 | $156.65 | |
Cigna
| Professional | $109.23 | $170.93 | $305.72 | |
United
| Professional | $140.90 | $196.66 | $393.32 |