| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $161.62 | $161.62 | $161.62 | |
Aetna
| Professional | $161.62 | $161.62 | $193.95 | |
Cigna
| Facility | $161.62 | $161.62 | $161.62 | |
Cigna
| Professional | $161.62 | $161.62 | $161.62 | |
United
| Professional | $140.61 | $161.62 | $161.62 |