| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $25.70 | $25.70 | $25.70 | |
Aetna
| Professional | $19.05 | $26.92 | $40.74 | |
Cigna
| Facility | $38.90 | $38.90 | $38.90 | |
Cigna
| Professional | $158.49 | $158.49 | $158.49 | |
United
| Facility | $81.28 | $81.28 | $81.28 | |
United
| Professional | $4.27 | $7.94 | $40.74 |