| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $125.89 | $147.91 | $147.91 | |
Aetna
| Professional | $125.89 | $125.89 | $154.88 | |
Cigna
| Facility | $131.83 | $131.83 | $131.83 | |
Cigna
| Professional | $398.11 | $398.11 | $398.11 | |
United
| Professional | $147.91 | $147.91 | $190.55 |