| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $121.18 | $146.88 | $166.45 | |
Cigna
| Facility | $174.77 | $174.77 | $174.77 | |
Cigna
| Professional | $127.58 | $127.58 | $174.77 | |
United
| Professional | $160.76 | $190.77 | $652.85 |