| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $77.62 | $77.62 | $102.33 | |
Aetna
| Professional | $95.50 | $100.00 | $102.33 | |
Cigna
| Facility | $102.33 | $194.98 | $194.98 | |
Cigna
| Professional | $102.33 | $102.33 | $549.54 | |
United
| Professional | $100.00 | $120.23 | $125.89 |