| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $140.28 | $140.28 | $140.28 | |
Aetna
| Professional | $134.88 | $134.88 | $140.28 | |
Cigna
| Facility | $127.25 | $134.88 | $134.88 | |
Cigna
| Professional | $134.88 | $134.88 | $134.88 | |
United
| Professional | $134.88 | $134.88 | $134.88 |