| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $63.11 | $63.11 | $63.11 | |
Aetna
| Professional | $63.11 | $66.50 | $66.50 | |
Cigna
| Facility | $65.83 | $76.43 | $79.00 | |
Cigna
| Professional | $69.31 | $80.55 | $315.83 | |
United
| Professional | $44.22 | $69.36 | $143.87 |