| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $11.54 | $11.54 | $11.54 | |
Aetna
| Professional | $11.54 | $17.12 | $17.12 | |
Cigna
| Facility | $21.21 | $21.21 | $21.21 | |
Cigna
| Professional | $19.44 | $40.32 | $321.32 | |
United
| Professional | $12.10 | $64.58 | $145.88 |