| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $145.49 | $145.49 | $145.49 | |
Cigna
| Facility | $145.49 | $145.49 | $145.49 | |
Cigna
| Professional | $145.49 | $145.49 | $145.49 | |
United
| Professional | $145.49 | $145.49 | $235.81 |