| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $203.84 | $203.84 | $203.84 | |
Aetna
| Professional | $118.76 | $118.76 | $147.12 | |
Cigna
| Facility | $115.21 | $115.21 | $115.21 | |
Cigna
| Professional | $331.31 | $331.31 | $331.31 | |
United
| Professional | $79.76 | $145.09 | $389.95 |