| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $138.74 | $138.74 | $138.74 | |
Aetna
| Professional | $138.74 | $138.74 | $152.61 | |
Cigna
| Facility | $138.74 | $138.74 | $138.74 | |
Cigna
| Professional | $138.74 | $138.74 | $258.05 | |
United
| Professional | $124.87 | $138.74 | $166.49 |