| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $146.74 | $146.74 | $146.74 | |
Aetna
| Professional | $146.74 | $146.74 | $508.74 | |
Cigna
| Facility | $64.00 | $64.00 | $64.00 | |
Cigna
| Professional | $259.57 | $259.57 | $259.57 | |
United
| Professional | $249.47 | $249.47 | $249.47 |