| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $106.02 | $117.83 | $117.83 | |
Cigna
| Facility | $166.23 | $166.23 | $166.23 | |
Cigna
| Professional | $121.35 | $121.35 | $166.23 | |
United
| Professional | $95.63 | $142.84 | $523.73 |