| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $124.81 | $124.81 | $125.37 | |
Cigna
| Facility | $170.96 | $170.96 | $170.96 | |
Cigna
| Professional | $124.80 | $124.80 | $124.80 | |
United
| Professional | $113.09 | $151.30 | $208.87 |