| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $181.84 | $213.46 | $213.46 | |
Aetna
| Professional | $141.75 | $167.51 | $172.63 | |
Cigna
| Facility | $1,175.26 | $1,175.26 | $1,175.26 | |
Cigna
| Professional | $115.25 | $148.28 | $311.97 | |
United
| Professional | $115.27 | $166.01 | $371.49 |