| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $45.61 | $55.08 | $74.56 | |
Aetna
| Professional | 26 | $13.12 | $16.43 | $20.07 |
Aetna
| Professional | TC | $32.49 | $38.44 | $54.50 |
Cigna
| Professional | $39.93 | $65.52 | $90.66 | |
Cigna
| Professional | 26 | $13.31 | $18.39 | $25.34 |
Cigna
| Professional | TC | $26.62 | $46.66 | $65.62 |
United
| Professional | $42.90 | $55.87 | $117.99 | |
United
| Professional | 26 | $12.54 | $16.73 | $34.50 |
United
| Professional | TC | $30.36 | $39.85 | $83.49 |