| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $69.37 | $178.28 | $8,731.31 | |
Aetna
| Professional | $69.37 | $69.37 | $87.40 | |
Cigna
| Facility | $75.58 | $75.58 | $75.58 | |
Cigna
| Professional | $69.37 | $69.37 | $69.37 | |
United
| Professional | $69.37 | $74.17 | $152.61 |