| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $107.15 | $107.15 | $112.20 | |
Cigna
| Facility | $100.00 | $100.00 | $120.23 | |
Cigna
| Professional | $107.15 | $107.15 | $107.15 | |
United
| Professional | $93.33 | $120.23 | $131.83 |