| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $109.53 | $109.53 | $109.53 | |
Aetna
| Professional | $72.90 | $83.17 | $85.61 | |
Cigna
| Facility | $137.77 | $137.77 | $137.77 | |
Cigna
| Professional | $63.78 | $83.28 | $154.51 | |
United
| Professional | $61.94 | $88.20 | $186.62 |