| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $129.16 | $129.16 | $16,288.41 | |
Aetna
| Professional | $99.49 | $129.16 | $149.53 | |
Cigna
| Professional | $147.91 | $147.91 | $147.91 | |
United
| Professional | $291.44 | $342.87 | $342.87 |