| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $51.29 | $51.29 | $51.29 | |
Aetna
| Professional | $30.20 | $37.15 | $134.90 | |
Cigna
| Facility | $29.51 | $29.51 | $29.51 | |
Cigna
| Professional | $30.20 | $30.20 | $30.20 | |
United
| Professional | $19.05 | $26.92 | $97.72 |