| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $108.35 | $109.82 | $1,253.19 | |
Aetna
| Professional | $104.53 | $108.36 | $108.36 | |
Cigna
| Facility | $108.36 | $108.36 | $108.36 | |
Cigna
| Professional | $108.36 | $108.36 | $108.36 | |
United
| Professional | $106.24 | $106.24 | $127.49 |