| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $123.03 | $123.03 | $125.89 | |
Aetna
| Professional | $123.03 | $123.03 | $134.90 | |
Cigna
| Facility | $117.49 | $123.03 | $199.53 | |
Cigna
| Professional | $123.03 | $537.03 | $537.03 | |
United
| Facility | $123.03 | $123.03 | $123.03 | |
United
| Professional | $120.23 | $123.03 | $199.53 |