| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $147.91 | $169.14 | $186.45 | |
Cigna
| Facility | $178.86 | $178.86 | $178.86 | |
Cigna
| Professional | $152.03 | $152.03 | $152.03 | |
United
| Professional | $75.17 | $117.44 | $249.77 |