| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $96.80 | $102.85 | $102.85 | |
Cigna
| Facility | $102.85 | $102.85 | $102.85 | |
Cigna
| Professional | $102.85 | $102.85 | $102.85 | |
United
| Professional | $102.88 | $110.00 | $242.00 |