| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $103.52 | $156.00 | $199.25 | |
Aetna
| Professional | TC | $81.88 | $129.07 | $165.05 |
Cigna
| Professional | $69.44 | $116.06 | $268.50 | |
Cigna
| Professional | TC | $46.42 | $129.62 | $228.13 |
United
| Professional | $77.73 | $117.78 | $303.36 | |
United
| Professional | TC | $43.76 | $97.29 | $241.58 |