| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $178.13 | $178.13 | $178.13 | |
Aetna
| Professional | $169.74 | $178.13 | $178.13 | |
Cigna
| Facility | $178.13 | $178.13 | $178.13 | |
Cigna
| Professional | $178.13 | $178.13 | $281.61 | |
United
| Professional | $176.52 | $202.90 | $202.90 |