| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $89.13 | $89.13 | $89.13 |
Aetna
| Professional | 26 | $89.13 | $117.49 | $154.88 |
Cigna
| Facility | 26 | $22.39 | $104.71 | $147.91 |
Cigna
| Professional | 26 | $97.72 | $309.03 | $691.83 |
United
| Professional | 26 | $61.66 | $89.13 | $158.49 |