| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $136.66 | $136.66 | $164.84 | |
Cigna
| Facility | $139.57 | $139.57 | $139.57 | |
Cigna
| Professional | $136.66 | $136.66 | $136.66 | |
United
| Professional | $135.12 | $144.87 | $205.01 |