| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $211.34 | $211.34 | $211.34 | |
Aetna
| Professional | $211.34 | $211.34 | $211.34 | |
Cigna
| Professional | $232.20 | $232.20 | $232.20 | |
United
| Professional | $196.95 | $234.27 | $248.78 |