| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $87.57 | $87.57 | $400.00 | |
Ambetter
| Professional | $650.00 | $650.00 | $650.00 | |
Cigna
| Professional | $107.80 | $293.25 | $293.25 | |
United
| Professional | $80.56 | $80.56 | $100.25 |