| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $77.62 | $77.62 | $138.04 | |
Aetna
| Professional | $128.82 | $134.90 | $162.18 | |
Cigna
| Facility | $162.18 | $162.18 | $162.18 | |
Cigna
| Professional | $162.18 | $162.18 | $162.18 | |
United
| Professional | $125.89 | $125.89 | $162.18 |