| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $36.58 | $36.58 | $36.58 | |
Aetna
| Professional | $42.24 | $42.24 | $44.88 | |
Cigna
| Facility | $44.88 | $44.88 | $44.88 | |
Cigna
| Professional | $44.88 | $44.88 | $44.88 | |
United
| Professional | $50.16 | $50.16 | $52.80 |