| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $114.82 | $114.82 | $114.82 | |
Aetna
| Professional | $112.20 | $114.82 | $141.25 | |
Cigna
| Facility | $141.25 | $141.25 | $141.25 | |
Cigna
| Professional | $120.23 | $120.23 | $120.23 | |
Select Health
| Professional | $117.49 | $128.82 | $128.82 | |
United
| Professional | $117.49 | $117.49 | $120.23 |