| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $354.20 | $354.20 | $354.20 | |
Aetna
| Professional | $206.36 | $206.36 | $255.64 | |
Cigna
| Facility | $200.20 | $200.20 | $200.20 | |
Cigna
| Professional | $220.87 | $220.87 | $220.87 | |
United
| Professional | $77.40 | $184.80 | $677.60 |