| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $20.89 | $20.89 | $20.89 | |
Aetna
| Professional | $19.95 | $20.89 | $21.38 | |
Cigna
| Facility | $85.11 | $85.11 | $85.11 | |
Cigna
| Professional | $114.82 | $114.82 | $114.82 | |
United
| Facility | $10.23 | $10.23 | $10.23 |