| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $110.63 | $139.26 | $199.34 | |
Aetna
| Professional | 25 | $381.88 | $390.94 | $400.22 |
Cigna
| Professional | $151.43 | $188.37 | $249.70 | |
United
| Professional | $146.03 | $184.82 | $242.03 |