| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $74.72 | $74.72 | $74.72 | |
Aetna
| Professional | $72.09 | $74.72 | $74.72 | |
Cigna
| Facility | $136.94 | $136.94 | $136.94 | |
Cigna
| Professional | $136.94 | $136.94 | $136.94 | |
United
| Facility | $185.99 | $185.99 | $226.91 | |
United
| Professional | $83.51 | $83.51 | $99.17 |