| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $168.09 | $168.09 | $168.09 | |
Aetna
| Professional | $161.62 | $161.62 | $168.09 | |
Cigna
| Facility | $152.47 | $161.62 | $161.62 | |
Cigna
| Professional | $161.62 | $161.62 | $161.62 | |
United
| Professional | $161.62 | $161.62 | $161.62 |