| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $57.97 | $57.97 | $57.97 | |
Aetna
| Professional | $39.82 | $58.85 | $58.85 | |
Cigna
| Facility | $32.77 | $32.77 | $32.77 | |
Cigna
| Professional | $36.94 | $57.82 | $101.11 | |
United
| Professional | $21.17 | $30.25 | $70.41 |