| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $122.56 | $143.07 | $168.31 | |
Aetna
| Professional | $122.56 | $138.90 | $168.31 | |
Aetna
| Professional | 25 | $240.88 | $240.88 | $240.88 |
Cigna
| Professional | $180.68 | $233.37 | $395.80 | |
United
| Professional | $157.41 | $180.32 | $236.35 |