| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $105.34 | $105.34 | $105.34 | |
Aetna
| Professional | $16.80 | $43.10 | $51.41 | |
Cigna
| Facility | $65.00 | $65.00 | $65.00 | |
Cigna
| Professional | $29.99 | $84.66 | $117.60 | |
United
| Professional | $21.64 | $43.29 | $159.83 |