| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $273.22 | $368.34 | $389.79 | |
Cigna
| Facility | $150.00 | $150.00 | $150.00 | |
Cigna
| Professional | $127.50 | $150.00 | $150.00 | |
United
| Professional | $175.70 | $288.48 | $526.32 |