| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $201.71 | $201.71 | $201.71 | |
Aetna
| Professional | $117.52 | $117.52 | $145.58 | |
Cigna
| Facility | $114.01 | $114.01 | $114.01 | |
Cigna
| Professional | $86.49 | $95.80 | $253.64 | |
United
| Professional | $73.67 | $105.24 | $385.88 |