| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $139.94 | $139.94 | $139.94 | |
Aetna
| Professional | $139.94 | $139.94 | $139.94 | |
Cigna
| Professional | $143.31 | $143.31 | $143.31 | |
United
| Professional | $133.47 | $140.50 | $140.50 |