| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $119.25 | $123.29 | $123.29 | |
Cigna
| Facility | $159.91 | $159.91 | $159.91 | |
Cigna
| Professional | $116.74 | $116.74 | $116.74 | |
United
| Professional | $115.93 | $149.44 | $202.62 |