| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $128.82 | $128.82 | $128.82 | |
Aetna
| Professional | $91.20 | $131.83 | $177.83 | |
Cigna
| Professional | $147.91 | $147.91 | $302.00 | |
United
| Professional | $125.89 | $125.89 | $173.78 |