| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $153.10 | $153.10 | $153.10 | |
Aetna
| Professional | $153.10 | $153.10 | $220.69 | |
Cigna
| Professional | $164.86 | $164.86 | $164.86 | |
United
| Professional | $150.69 | $185.79 | $270.01 |