| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $139.21 | $139.21 | $167.79 | |
Cigna
| Facility | $143.25 | $143.25 | $143.25 | |
Cigna
| Professional | $139.21 | $139.21 | $139.21 | |
United
| Professional | $128.90 | $147.56 | $178.19 |