| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $108.60 | $108.60 | $108.60 | |
Aetna
| Professional | $137.93 | $150.34 | $151.72 | |
Cigna
| Facility | $130.12 | $130.12 | $130.12 | |
Cigna
| Professional | $137.93 | $195.18 | $195.18 | |
United
| Professional | $137.93 | $137.93 | $137.93 |