| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $46.77 | $46.77 | $46.77 | |
Aetna
| Professional | $34.67 | $52.48 | $60.26 | |
Cigna
| Facility | $95.50 | $95.50 | $95.50 | |
Cigna
| Professional | $257.04 | $257.04 | $257.04 | |
United
| Facility | $104.71 | $104.71 | $104.71 | |
United
| Professional | $40.74 | $60.26 | $100.00 |