| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $14.82 | $14.82 | $14.82 | |
Aetna
| Professional | $14.82 | $14.82 | $24.57 | |
Cigna
| Facility | $64.00 | $64.00 | $64.00 | |
Cigna
| Professional | $4.38 | $4.38 | $15.47 | |
United
| Professional | $4.82 | $5.91 | $12.23 |