| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $149.72 | $196.31 | $254.75 | |
Aetna
| Professional | 25 | $538.02 | $538.02 | $538.02 |
Cigna
| Professional | $220.83 | $265.66 | $352.11 | |
United
| Professional | $201.18 | $251.48 | $680.00 |