| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $162.18 | $162.18 | $165.96 | |
Aetna
| Professional | $162.18 | $162.18 | $181.97 | |
Cigna
| Facility | $154.88 | $162.18 | $245.47 | |
Cigna
| Professional | $162.18 | $691.83 | $691.83 | |
United
| Facility | $162.18 | $162.18 | $162.18 | |
United
| Professional | $158.49 | $162.18 | $239.88 |