| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $126.63 | $126.63 | $138.06 | |
Cigna
| Facility | $218.57 | $218.57 | $218.57 | |
Cigna
| Professional | $159.56 | $159.56 | $218.57 | |
United
| Professional | $124.53 | $153.50 | $231.25 |