| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $196.02 | $196.02 | $218.26 | |
Cigna
| Facility | $297.62 | $297.62 | $297.62 | |
Cigna
| Professional | $217.26 | $217.26 | $297.62 | |
United
| Professional | $196.87 | $237.62 | $363.62 |