| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $91.36 | $164.44 | $195.76 |
Aetna
| Professional | 26 | $91.36 | $164.44 | $200.00 |
Cigna
| Professional | 26 | $89.88 | $152.88 | $210.39 |
United
| Professional | 26 | $76.66 | $94.92 | $158.88 |