| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $114.37 | $115.90 | $115.90 | |
Cigna
| Facility | $185.61 | $185.61 | $185.61 | |
Cigna
| Professional | $135.50 | $135.50 | $185.61 | |
United
| Facility | $195.26 | $195.26 | $195.26 | |
United
| Professional | $103.16 | $140.49 | $211.62 |