| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $74.94 | $104.64 | $145.56 | |
Aetna
| Professional | TC | $36.79 | $57.36 | $75.97 |
Cigna
| Professional | $69.92 | $86.51 | $176.33 | |
Cigna
| Professional | TC | $19.17 | $38.10 | $94.33 |
United
| Professional | $69.78 | $86.71 | $225.04 | |
United
| Professional | TC | $18.70 | $47.70 | $126.47 |