| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $130.91 | $130.91 | $130.91 | |
Aetna
| Professional | $55.09 | $129.10 | $144.80 | |
Cigna
| Professional | $128.26 | $128.26 | $161.63 | |
Martin's Point
| Professional | $55.09 | $130.91 | $158.90 | |
United
| Professional | $119.65 | $197.53 | $297.64 |