| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $63.18 | $107.88 | $1,200.00 | |
Aetna
| Professional | $87.00 | $120.66 | $222.95 | |
Cigna
| Facility | $128.28 | $128.28 | $128.28 | |
Cigna
| Professional | $153.85 | $153.85 | $806.05 | |
United
| Professional | $195.38 | $268.22 | $436.20 |