| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $58.88 | $58.88 | $58.88 | |
Aetna
| Professional | $33.88 | $41.69 | $154.88 | |
Cigna
| Facility | $33.11 | $33.11 | $33.11 | |
Cigna
| Professional | $33.88 | $33.88 | $33.88 | |
United
| Professional | $21.38 | $30.90 | $112.20 |