| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $245.47 | $245.47 | $346.74 | |
Cigna
| Facility | $245.47 | $245.47 | $245.47 | |
Cigna
| Professional | $245.47 | $245.47 | $245.47 | |
United
| Professional | $125.89 | $257.04 | $371.54 |