| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $112.20 | $162.18 | $346.74 | |
Aetna
| Professional | 25 | $162.18 | $371.54 | $398.11 |
Cigna
| Professional | $151.36 | $186.21 | $234.42 | |
United
| Professional | $104.71 | $165.96 | $234.42 |