| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $204.17 | $204.17 | $213.80 | |
Cigna
| Facility | $194.98 | $194.98 | $234.42 | |
Cigna
| Professional | $204.17 | $204.17 | $204.17 | |
United
| Professional | $125.89 | $1,000.00 | $1,071.52 |