| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $125.02 | $127.54 | $164.33 | |
Aetna
| Professional | $107.70 | $131.63 | $200.22 | |
Aetna
| Professional | 25 | $170.76 | $170.76 | $170.76 |
Cigna
| Professional | $142.88 | $147.90 | $178.59 | |
United
| Professional | $177.46 | $289.94 | $404.50 |