| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $104.78 | $166.65 | $166.65 | |
Aetna
| Professional | $108.57 | $166.65 | $201.00 | |
Cigna
| Facility | $182.89 | $182.89 | $182.89 | |
Cigna
| Professional | $141.06 | $141.06 | $739.00 | |
United
| Professional | $145.34 | $213.53 | $305.12 |