| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $90.00 | $90.00 | $90.00 | |
Aetna
| Professional | $61.83 | $64.95 | $64.95 | |
Cigna
| Facility | $50.87 | $50.87 | $50.87 | |
Cigna
| Professional | $62.69 | $90.03 | $171.30 | |
United
| Professional | $32.86 | $46.96 | $109.34 |