| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $127.55 | $127.55 | $127.55 | |
Aetna
| Professional | $127.55 | $127.55 | $134.00 | |
Cigna
| Professional | $134.47 | $134.47 | $134.47 | |
United
| Professional | $114.06 | $135.66 | $144.07 |