| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $166.77 | $166.77 | $197.42 | |
Cigna
| Facility | $253.20 | $253.20 | $253.20 | |
Cigna
| Professional | $184.84 | $184.84 | $253.20 | |
United
| Professional | $182.53 | $202.16 | $304.52 |