| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $112.24 | $112.24 | $112.24 | |
Aetna
| Professional | $112.24 | $151.91 | $575.67 | |
Cigna
| Facility | $183.96 | $248.86 | $248.86 | |
Cigna
| Professional | $183.96 | $183.96 | $183.96 | |
United
| Professional | $208.60 | $215.05 | $215.05 |