| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $238.58 | $238.58 | $238.58 | |
Aetna
| Professional | $139.00 | $139.00 | $172.19 | |
Cigna
| Facility | $134.85 | $134.85 | $134.85 | |
Cigna
| Professional | $387.76 | $387.76 | $387.76 | |
United
| Professional | $87.13 | $169.82 | $456.41 |