| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $76.70 | $76.70 | $76.70 | |
Aetna
| Professional | $52.69 | $55.36 | $55.36 | |
Cigna
| Facility | $43.36 | $43.36 | $43.36 | |
Cigna
| Professional | $50.62 | $76.41 | $138.41 | |
United
| Professional | $28.01 | $40.02 | $93.16 |