| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $109.54 | $109.54 | $116.08 | |
Cigna
| Facility | $210.68 | $210.68 | $210.68 | |
Cigna
| Professional | $153.80 | $153.80 | $210.68 | |
United
| Professional | $141.65 | $174.23 | $299.30 |