| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $65.33 | $65.33 | $65.33 | |
Aetna
| Professional | $50.31 | $65.33 | $76.62 | |
Cigna
| Facility | $93.13 | $93.13 | $93.13 | |
Cigna
| Professional | $93.13 | $93.13 | $93.13 | |
United
| Professional | $77.61 | $91.30 | $91.30 |