| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $12.69 | $12.69 | $12.69 | |
Aetna
| Professional | $12.69 | $15.55 | $19.14 | |
Cigna
| Facility | $17.48 | $17.48 | $17.48 | |
Cigna
| Professional | $14.16 | $19.71 | $73.45 | |
United
| Professional | $10.98 | $18.27 | $33.79 |