| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $180.20 | $180.20 | $180.20 | |
Aetna
| Professional | $180.20 | $180.20 | $180.20 | |
Cigna
| Professional | $203.81 | $203.81 | $203.81 | |
United
| Professional | $172.87 | $212.00 | $218.36 |