| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $89.34 | $89.34 | $89.34 |
Aetna
| Professional | 26 | $89.34 | $125.00 | $125.00 |
Cigna
| Facility | 26 | $104.54 | $104.54 | $104.54 |
Cigna
| Professional | 26 | $98.60 | $119.60 | $690.00 |
United
| Professional | 26 | $61.35 | $92.03 | $169.50 |