| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $173.78 | $173.78 | $173.78 | |
Aetna
| Professional | $114.82 | $151.36 | $186.21 | |
Cigna
| Professional | $173.78 | $173.78 | $218.78 | |
United
| Professional | $117.49 | $162.18 | $213.80 |