| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $128.82 | $128.82 | $128.82 | |
Aetna
| Professional | $128.82 | $128.82 | $141.25 | |
Cigna
| Facility | $123.03 | $128.82 | $194.98 | |
Cigna
| Professional | $128.82 | $549.54 | $549.54 | |
United
| Facility | $128.82 | $128.82 | $128.82 | |
United
| Professional | $125.89 | $128.82 | $147.91 |