| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $151.16 | $151.16 | $167.94 | |
Cigna
| Facility | $151.16 | $151.16 | $151.16 | |
Cigna
| Professional | $151.16 | $151.16 | $151.16 | |
United
| Professional | $151.16 | $151.16 | $332.57 |