| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $142.38 | $151.27 | $151.27 | |
Cigna
| Facility | $151.27 | $151.27 | $151.27 | |
Cigna
| Professional | $151.27 | $151.27 | $151.27 | |
United
| Professional | $151.27 | $161.79 | $355.94 |