| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $216.92 | $216.92 | $216.92 | |
Cigna
| Facility | $238.19 | $238.19 | $238.19 | |
Cigna
| Professional | $238.19 | $238.19 | $238.19 | |
United
| Professional | $219.05 | $219.05 | $255.20 |