| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $16.98 | $16.98 | $16.98 | |
Aetna
| Professional | $16.98 | $251.19 | $257.04 | |
Cigna
| Facility | $64.57 | $64.57 | $64.57 | |
Cigna
| Professional | $15.14 | $15.14 | $15.14 | |
Emblem Health
| Professional | $371.54 | $371.54 | $371.54 | |
United
| Professional | $95.50 | $95.50 | $107.15 |