| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $87.91 | $87.91 | $116.04 | |
Aetna
| Professional | $87.91 | $87.91 | $87.91 | |
Cigna
| Facility | $136.94 | $136.94 | $136.94 | |
Cigna
| Professional | $136.94 | $136.94 | $136.94 | |
United
| Facility | $226.91 | $226.91 | $226.91 | |
United
| Professional | $81.84 | $83.51 | $96.04 |