| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $85.03 | $85.03 | $85.03 | |
Aetna
| Professional | $85.03 | $85.03 | $197.44 | |
Cigna
| Facility | $130.90 | $130.90 | $130.90 | |
Cigna
| Professional | $75.23 | $75.23 | $75.23 | |
United
| Professional | $89.89 | $89.89 | $89.89 |