| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $138.04 | $138.04 | $138.04 | |
Aetna
| Professional | $128.82 | $138.04 | $138.04 | |
Cigna
| Facility | $138.04 | $138.04 | $138.04 | |
Cigna
| Professional | $138.04 | $138.04 | $138.04 | |
United
| Professional | $154.88 | $154.88 | $154.88 |