| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $97.72 | $117.49 | $169.82 | |
Cigna
| Facility | $302.00 | $302.00 | $302.00 | |
Cigna
| Professional | $147.91 | $147.91 | $302.00 | |
United
| Professional | $107.15 | $125.89 | $151.36 |