| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $128.75 | $128.75 | $128.75 | |
Aetna
| Professional | $123.80 | $123.80 | $128.75 | |
Cigna
| Facility | $116.79 | $123.80 | $123.80 | |
Cigna
| Professional | $123.80 | $123.80 | $123.80 | |
United
| Professional | $123.80 | $123.80 | $123.80 |