| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $87.36 | $87.36 | $87.36 |
Aetna
| Professional | 26 | $87.36 | $125.00 | $291.50 |
Cigna
| Facility | 26 | $99.80 | $99.80 | $99.80 |
Cigna
| Professional | 26 | $101.09 | $114.04 | $403.82 |
United
| Professional | 26 | $61.70 | $95.62 | $200.69 |