| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $141.25 | $151.36 | $151.36 | |
Cigna
| Facility | $151.36 | $151.36 | $151.36 | |
Cigna
| Professional | $151.36 | $151.36 | $151.36 | |
United
| Professional | $125.89 | $151.36 | $173.78 |