| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $131.83 | $131.83 | $131.83 | |
Aetna
| Professional | $89.13 | $93.33 | $114.82 | |
Cigna
| Facility | $74.13 | $74.13 | $74.13 | |
Cigna
| Professional | $131.83 | $131.83 | $165.96 | |
United
| Professional | $39.81 | $69.18 | $169.82 |