| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $156.97 | $156.97 | $174.25 | |
Aetna
| Professional | $156.97 | $156.97 | $174.25 | |
Cigna
| Facility | $66.90 | $172.37 | $172.37 | |
Cigna
| Professional | $172.37 | $172.37 | $172.37 | |
United
| Professional | $146.21 | $153.90 | $177.39 |