| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $41.88 | $119.61 | $119.61 | |
Aetna
| Professional | $119.61 | $119.61 | $119.61 | |
Cigna
| Professional | $131.35 | $131.35 | $131.35 | |
United
| Professional | $111.42 | $132.53 | $140.74 |