| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $80.61 | $80.61 | $769.12 | |
Aetna
| Professional | $57.80 | $80.61 | $91.98 | |
Cigna
| Facility | $179.95 | $179.95 | $179.95 | |
Cigna
| Professional | $67.45 | $67.45 | $67.45 | |
United
| Professional | $202.00 | $202.00 | $202.00 |