| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $64.57 | $64.57 | $64.57 | |
Aetna
| Professional | $57.54 | $66.07 | $75.86 | |
Cigna
| Facility | $107.15 | $107.15 | $107.15 | |
Cigna
| Professional | $64.57 | $169.82 | $323.59 | |
United
| Professional | $54.95 | $79.43 | $117.49 |