| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $26.92 | $26.92 | $26.92 | |
Aetna
| Professional | $22.91 | $23.44 | $26.92 | |
Cigna
| Facility | $21.38 | $21.38 | $21.38 | |
Cigna
| Professional | $11.48 | $26.92 | $33.88 | |
United
| Professional | $3.16 | $12.59 | $50.12 |