| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $39.74 | $39.74 | $69.69 |
Aetna
| Professional | $119.53 | $119.53 | $151.71 | |
Aetna
| Professional | 26 | $23.78 | $25.03 | $27.87 |
Cigna
| Professional | $86.67 | $133.38 | $265.98 | |
Cigna
| Professional | 26 | $20.46 | $30.07 | $50.51 |
United
| Professional | $111.00 | $155.16 | $310.66 | |
United
| Professional | 26 | $22.21 | $30.30 | $64.73 |