| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $142.44 | $142.44 | $209.28 | |
Cigna
| Facility | $197.94 | $197.94 | $197.94 | |
Cigna
| Professional | $144.50 | $144.50 | $197.94 | |
United
| Professional | $130.94 | $172.67 | $260.10 |