| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $47.86 | $47.86 | $47.86 | |
Aetna
| Professional | $26.92 | $33.88 | $125.89 | |
Cigna
| Facility | $26.92 | $26.92 | $26.92 | |
Cigna
| Professional | $26.92 | $30.20 | $83.18 | |
United
| Professional | $17.38 | $23.99 | $91.20 |