| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $177.26 | $177.26 | $177.26 | |
Aetna
| Professional | $143.88 | $173.09 | $177.26 | |
Cigna
| Facility | $177.26 | $212.71 | $275.27 | |
Cigna
| Professional | $177.26 | $177.26 | $177.26 | |
Emblem Health
| Professional | $159.54 | $177.26 | $177.26 |