| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $88.81 | $88.81 | $88.81 |
Aetna
| Professional | 26 | $88.81 | $125.00 | $125.00 |
Cigna
| Facility | 26 | $102.10 | $102.10 | $102.10 |
Cigna
| Professional | 26 | $95.48 | $117.21 | $690.00 |
United
| Professional | 26 | $60.08 | $87.81 | $163.78 |