| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $131.83 | $162.18 | $165.96 | |
Cigna
| Facility | $162.18 | $162.18 | $162.18 | |
Cigna
| Professional | $162.18 | $162.18 | $162.18 | |
United
| Professional | $125.89 | $151.36 | $177.83 |