| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $112.20 | $112.20 | $120.23 | |
Cigna
| Facility | $107.15 | $107.15 | $125.89 | |
Cigna
| Professional | $112.20 | $112.20 | $112.20 | |
United
| Professional | $125.89 | $776.25 | $933.25 |