| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $53.59 | $53.59 | $53.59 | |
Aetna
| Professional | $31.22 | $31.22 | $38.68 | |
Cigna
| Facility | $30.29 | $30.29 | $30.29 | |
Cigna
| Professional | $80.01 | $80.01 | $80.01 | |
United
| Professional | $20.97 | $35.04 | $102.52 |