| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $182.18 | $182.18 | $182.18 | |
Cigna
| Facility | $182.18 | $182.18 | $182.18 | |
Cigna
| Professional | $182.18 | $182.18 | $182.18 | |
United
| Professional | $182.18 | $182.18 | $476.82 |