| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $101.03 | $101.03 | $102.04 | |
Cigna
| Facility | $101.03 | $101.03 | $101.03 | |
Cigna
| Professional | $101.03 | $101.03 | $101.03 | |
United
| Professional | $101.03 | $101.03 | $222.27 |