| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $199.71 | $199.71 | $199.71 | |
Aetna
| Professional | $116.35 | $116.35 | $144.13 | |
Cigna
| Facility | $112.88 | $112.88 | $112.88 | |
Cigna
| Professional | $119.35 | $134.16 | $334.37 | |
United
| Professional | $104.20 | $181.30 | $382.05 |