| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $46.77 | $57.54 | $165.96 | |
Cigna
| Facility | $87.10 | $87.10 | $87.10 | |
Cigna
| Professional | $63.10 | $63.10 | $63.10 | |
United
| Facility | $0.11 | $77.62 | $93.33 | |
United
| Professional | $63.10 | $74.13 | $104.71 |