| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $167.33 | $167.33 | $206.15 | |
Cigna
| Facility | $218.27 | $218.27 | $218.27 | |
Cigna
| Professional | $159.34 | $159.34 | $218.27 | |
United
| Professional | $139.46 | $202.84 | $275.00 |