| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $178.52 | $178.52 | $264.47 | |
Cigna
| Facility | $252.60 | $252.60 | $252.60 | |
Cigna
| Professional | $184.40 | $184.40 | $184.40 | |
United
| Professional | $165.46 | $216.41 | $325.99 |