| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $63.84 | $63.84 | $63.84 | |
Aetna
| Professional | $63.84 | $63.84 | $63.84 | |
Cigna
| Facility | $98.58 | $98.58 | $98.58 | |
Cigna
| Professional | $413.17 | $413.17 | $700.59 | |
United
| Professional | $66.97 | $118.96 | $377.62 |