| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $128.49 | $163.06 | $421.78 | |
Aetna
| Professional | 26 | $41.16 | $49.63 | $125.43 |
Aetna
| Professional | TC | $87.33 | $112.20 | $296.33 |
Cigna
| Professional | $120.42 | $191.09 | $270.77 | |
Cigna
| Professional | 26 | $41.69 | $54.74 | $79.56 |
Cigna
| Professional | TC | $88.86 | $133.72 | $202.28 |
United
| Professional | $117.39 | $193.53 | $322.37 | |
United
| Professional | 26 | $37.34 | $53.65 | $102.68 |
United
| Professional | TC | $80.68 | $168.39 | $230.28 |