| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $51.94 | $51.94 | $51.94 | |
Aetna
| Professional | $12.94 | $13.26 | $13.58 | |
Cigna
| Facility | $13.58 | $13.58 | $13.58 | |
Cigna
| Professional | $13.58 | $13.58 | $13.58 | |
United
| Professional | $2.02 | $2.29 | $3.96 |