| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $162.18 | $162.18 | $181.97 | |
Aetna
| Professional | $162.18 | $162.18 | $194.98 | |
Ambetter
| Professional | $89.13 | $128.82 | $154.88 | |
Cigna
| Facility | $89.13 | $181.97 | $181.97 | |
Cigna
| Professional | $181.97 | $181.97 | $181.97 | |
United
| Professional | $162.18 | $177.83 | $194.98 |