| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $66.80 | $66.80 | $66.80 |
Aetna
| Professional | $170.43 | $170.43 | $244.99 | |
Cigna
| Professional | $73.44 | $170.03 | $217.20 | |
United
| Professional | $105.46 | $198.00 | $630.83 |