| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $158.31 | $159.10 | $159.10 | |
Cigna
| Facility | $215.87 | $215.87 | $215.87 | |
Cigna
| Professional | $157.59 | $157.59 | $215.87 | |
United
| Professional | $142.80 | $192.86 | $290.51 |