| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $100.00 | $100.00 | $100.00 | |
Aetna
| Professional | $100.00 | $100.00 | $120.23 | |
Cigna
| Facility | $100.00 | $100.00 | $100.00 | |
Cigna
| Professional | $100.00 | $100.00 | $100.00 | |
United
| Facility | $104.71 | $104.71 | $251.19 | |
United
| Professional | $104.71 | $125.89 | $165.96 |