| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $74.72 | $74.72 | $74.72 | |
Aetna
| Professional | $74.72 | $74.72 | $74.72 | |
Cigna
| Facility | $136.94 | $136.94 | $247.92 | |
Cigna
| Professional | $136.94 | $136.94 | $1,214.54 | |
United
| Professional | $81.00 | $83.51 | $120.95 |