| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $95.26 | $95.27 | $289.85 | |
Aetna
| Professional | $91.91 | $95.27 | $102.33 | |
Ambetter
| Professional | $67.25 | $67.25 | $111.80 | |
Cigna
| Facility | $95.27 | $95.27 | $95.27 | |
Cigna
| Professional | $95.27 | $95.27 | $95.27 | |
United
| Professional | $100.00 | $100.00 | $120.00 |