| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $174.10 | $174.10 | $174.10 | |
Aetna
| Professional | $173.90 | $174.10 | $280.58 | |
Cigna
| Facility | $64.00 | $64.00 | $64.00 | |
Cigna
| Professional | $161.72 | $161.72 | $161.72 | |
United
| Professional | $269.67 | $269.67 | $269.67 |