| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $134.90 | $134.90 | $134.90 | |
Aetna
| Professional | $134.90 | $134.90 | $154.88 | |
Cigna
| Facility | $134.90 | $134.90 | $134.90 | |
Cigna
| Professional | $134.90 | $134.90 | $134.90 | |
United
| Facility | $123.03 | $138.04 | $165.96 | |
United
| Professional | $107.15 | $128.82 | $144.54 |