| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $213.15 | $213.15 | $213.15 | |
Aetna
| Professional | $204.96 | $204.96 | $213.15 | |
Cigna
| Facility | $193.35 | $204.96 | $204.96 | |
Cigna
| Professional | $204.96 | $204.96 | $204.96 | |
United
| Professional | $204.96 | $204.96 | $204.96 |