| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $145.49 | $145.49 | $145.49 | |
Aetna
| Professional | $145.49 | $145.49 | $160.04 | |
Cigna
| Facility | $145.49 | $145.49 | $145.49 | |
Cigna
| Professional | $145.49 | $145.49 | $145.49 | |
United
| Professional | $126.58 | $145.49 | $145.49 |