| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $137.72 | $137.72 | $137.72 | |
Aetna
| Professional | $137.72 | $137.72 | $137.72 | |
Cigna
| Facility | $85.00 | $137.72 | $137.72 | |
Cigna
| Professional | $137.72 | $137.72 | $162.02 | |
United
| Professional | $153.91 | $153.91 | $246.27 |