| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $162.08 | $162.08 | $162.08 | |
Aetna
| Professional | $131.28 | $162.08 | $162.08 | |
Christus
| Facility | $121.37 | $121.37 | $121.37 | |
Cigna
| Facility | $162.08 | $162.08 | $162.08 | |
Cigna
| Professional | $162.08 | $162.08 | $162.08 | |
United
| Professional | $154.00 | $162.08 | $178.69 |