| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $41.69 | $41.69 | $41.69 | |
Aetna
| Professional | $23.99 | $30.20 | $109.65 | |
Cigna
| Facility | $23.99 | $23.99 | $23.99 | |
Cigna
| Professional | $24.55 | $24.55 | $24.55 | |
United
| Professional | $15.49 | $21.88 | $81.28 |