| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $108.94 | $108.94 | $121.29 | |
Cigna
| Facility | $165.40 | $165.40 | $165.40 | |
Cigna
| Professional | $120.74 | $120.74 | $165.40 | |
United
| Professional | $109.41 | $132.05 | $198.93 |