| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $283.50 | $283.50 | $283.50 | |
Aetna
| Professional | $165.17 | $165.17 | $204.61 | |
Cigna
| Facility | $160.24 | $160.24 | $160.24 | |
Cigna
| Professional | $338.67 | $338.67 | $338.67 | |
United
| Professional | $103.54 | $148.28 | $542.34 |