| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $57.54 | $64.57 | $93.33 | |
Cigna
| Facility | $112.20 | $112.20 | $112.20 | |
Cigna
| Professional | $70.79 | $93.33 | $162.18 | |
Medcost
| Facility | $61.66 | $83.18 | $144.54 | |
Medcost
| Professional | $144.54 | $144.54 | $144.54 | |
United
| Professional | $64.57 | $79.43 | $123.03 |