| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $168.52 | $168.52 | $168.52 | |
Aetna
| Professional | $168.52 | $184.04 | $184.04 | |
Cigna
| Facility | $208.03 | $529.72 | $650.73 | |
Cigna
| Professional | $163.53 | $220.92 | $857.53 | |
United
| Professional | $117.60 | $171.30 | $310.68 |