| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $120.72 | $120.72 | $153.16 | |
Cigna
| Facility | $278.10 | $278.10 | $278.10 | |
Cigna
| Professional | $203.01 | $203.01 | $278.10 | |
United
| Professional | $160.69 | $203.47 | $319.22 |