| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $214.53 | $229.24 | $596.39 | |
Aetna
| Professional | 26 | $72.23 | $80.40 | $294.07 |
Aetna
| Professional | TC | $140.86 | $148.83 | $167.87 |
Cigna
| Professional | $158.68 | $205.38 | $373.91 | |
Cigna
| Professional | 26 | $65.64 | $86.75 | $125.63 |
Cigna
| Professional | TC | $92.14 | $128.49 | $247.42 |
United
| Professional | $157.38 | $193.74 | $432.78 | |
United
| Professional | 26 | $58.92 | $85.02 | $162.03 |
United
| Professional | TC | $85.13 | $126.76 | $270.75 |