| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $102.33 | $125.89 | $363.08 | |
Cigna
| Facility | $190.55 | $190.55 | $190.55 | |
Cigna
| Professional | $138.04 | $138.04 | $138.04 | |
United
| Facility | $0.24 | $151.36 | $199.53 | |
United
| Professional | $138.04 | $162.18 | $234.42 |