| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $83.31 | $83.31 | $83.31 |
Aetna
| Professional | 26 | $83.31 | $125.00 | $291.50 |
Cigna
| Facility | 26 | $95.81 | $95.81 | $95.81 |
Cigna
| Professional | 26 | $97.22 | $108.73 | $1,674.63 |
United
| Professional | 26 | $60.43 | $81.91 | $163.40 |