| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $85.11 | $104.71 | $302.00 | |
Cigna
| Facility | $169.82 | $169.82 | $169.82 | |
Cigna
| Professional | $123.03 | $123.03 | $123.03 | |
United
| Facility | $0.18 | $114.82 | $131.83 | |
United
| Professional | $114.82 | $134.90 | $190.55 |