| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $142.31 | $167.06 | $868.00 | |
Aetna
| Professional | $106.75 | $125.50 | $128.99 | |
Cigna
| Facility | $4,783.89 | $4,783.89 | $4,783.89 | |
Cigna
| Professional | $101.20 | $224.27 | $575.51 | |
United
| Professional | $117.59 | $272.23 | $611.14 |