| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $104.31 | $104.31 | $119.65 | |
Cigna
| Facility | $168.00 | $168.00 | $168.00 | |
Cigna
| Professional | $122.64 | $122.64 | $122.64 | |
United
| Professional | $95.89 | $126.45 | $190.48 |