| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $73.78 | $103.10 | $132.77 | |
Aetna
| Professional | 26 | $26.90 | $36.50 | $47.18 |
Aetna
| Professional | TC | $46.88 | $66.61 | $85.57 |
Cigna
| Professional | $79.78 | $96.09 | $402.96 | |
Cigna
| Professional | 26 | $28.98 | $38.14 | $162.10 |
Cigna
| Professional | TC | $50.81 | $57.95 | $240.86 |
United
| Professional | $91.14 | $124.83 | $289.08 | |
United
| Professional | 26 | $30.58 | $44.67 | $103.44 |
United
| Professional | TC | $42.60 | $84.38 | $185.64 |