| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $91.20 | $165.96 | $165.96 |
Aetna
| Professional | 26 | $91.20 | $125.89 | $199.53 |
Cigna
| Professional | 26 | $93.33 | $162.18 | $208.93 |
United
| Professional | 26 | $79.43 | $97.72 | $173.78 |