| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $86.94 | $86.94 | $86.94 | |
Aetna
| Professional | $50.65 | $62.75 | $62.75 | |
Cigna
| Facility | $49.14 | $49.14 | $49.14 | |
Cigna
| Professional | $14.92 | $41.23 | $108.93 | |
United
| Professional | $12.57 | $31.75 | $166.32 |