| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $162.18 | $162.18 | $169.82 | |
Aetna
| Professional | $162.18 | $162.18 | $275.42 | |
Cigna
| Facility | $141.25 | $141.25 | $141.25 | |
Cigna
| Professional | $162.18 | $162.18 | $162.18 | |
United
| Professional | $162.18 | $169.82 | $194.98 |