| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $77.62 | $77.62 | $77.62 | |
Aetna
| Professional | $67.61 | $79.43 | $91.20 | |
Cigna
| Facility | $125.89 | $125.89 | $125.89 | |
Cigna
| Professional | $54.95 | $100.00 | $380.19 | |
United
| Professional | $63.10 | $91.20 | $134.90 |