| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $208.93 | $208.93 | $218.78 | |
Cigna
| Facility | $213.80 | $213.80 | $213.80 | |
Cigna
| Professional | $208.93 | $208.93 | $208.93 | |
United
| Professional | $208.93 | $223.87 | $239.88 |