| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $100.00 | $100.00 | $165.96 | |
Aetna
| Professional | $100.00 | $134.90 | $186.21 | |
CDPHP
| Facility | $208.93 | $208.93 | $208.93 | |
CDPHP
| Professional | $208.93 | $208.93 | $208.93 | |
Cigna
| Professional | $173.78 | $173.78 | $218.78 | |
United
| Professional | $56.23 | $134.90 | $177.83 |