| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $22.39 | $22.39 | $22.39 | |
Aetna
| Professional | $15.14 | $15.85 | $58.88 | |
Cigna
| Facility | $12.59 | $12.59 | $12.59 | |
Cigna
| Professional | $15.14 | $22.91 | $38.90 | |
United
| Professional | $8.32 | $14.13 | $123.03 |