| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $100.17 | $100.17 | $100.17 | |
Aetna
| Professional | $96.20 | $96.20 | $100.17 | |
Cigna
| Facility | $117.28 | $117.28 | $299.52 | |
Cigna
| Professional | $114.76 | $136.43 | $643.34 | |
United
| Professional | $83.20 | $180.26 | $476.18 |