| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $177.83 | $177.83 | $177.83 | |
Aetna
| Professional | $165.96 | $173.78 | $177.83 | |
Cigna
| Facility | $177.83 | $177.83 | $177.83 | |
Cigna
| Professional | $177.83 | $177.83 | $177.83 | |
United
| Facility | $181.97 | $181.97 | $181.97 |