| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $283.57 | $283.57 | $283.57 | |
Aetna
| Professional | $3.40 | $13.01 | $13.01 | |
Cigna
| Facility | $17.32 | $17.32 | $17.32 | |
Cigna
| Professional | $17.32 | $17.32 | $17.32 | |
United
| Professional | $20.38 | $20.38 | $20.38 |