| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $153.13 | $153.13 | $159.61 | |
Aetna
| Professional | $153.13 | $170.58 | $200.14 | |
Ambetter
| Professional | $199.09 | $199.09 | $199.09 | |
Cigna
| Professional | $45.05 | $45.05 | $45.05 | |
United
| Professional | $161.71 | $161.71 | $161.71 |