| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $79.43 | $83.18 | $288.40 | |
Cigna
| Facility | $123.03 | $123.03 | $123.03 | |
Cigna
| Professional | $91.20 | $91.20 | $91.20 | |
United
| Facility | $0.15 | $107.15 | $114.82 | |
United
| Professional | $91.20 | $109.65 | $158.49 |