| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $102.33 | $102.33 | $102.33 | |
Aetna
| Professional | $93.33 | $102.33 | $131.83 | |
Cigna
| Facility | $186.21 | $186.21 | $186.21 | |
Cigna
| Professional | $107.15 | $107.15 | $562.34 | |
United
| Professional | $102.33 | $147.91 | $218.78 |