| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $108.95 | $108.95 | $108.95 | |
Aetna
| Professional | $63.48 | $63.48 | $78.63 | |
Cigna
| Facility | $61.58 | $61.58 | $61.58 | |
Cigna
| Professional | $171.79 | $171.79 | $171.79 | |
United
| Professional | $39.79 | $75.15 | $208.43 |