| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $90.02 | $162.04 | $192.90 |
Aetna
| Professional | 26 | $90.00 | $130.32 | $200.00 |
Ambetter
| Professional | 26 | $64.27 | $64.27 | $64.27 |
Cigna
| Professional | 26 | $89.61 | $152.74 | $209.50 |
United
| Professional | 26 | $72.77 | $94.55 | $160.68 |