| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $121.03 | $121.03 | $126.33 | |
Cigna
| Facility | $190.78 | $190.78 | $190.78 | |
Cigna
| Professional | $139.27 | $139.27 | $190.78 | |
United
| Professional | $118.16 | $146.71 | $198.88 |