| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $104.69 | $104.69 | $104.69 | |
Aetna
| Professional | $84.99 | $104.69 | $104.69 | |
Cigna
| Professional | $62.16 | $62.16 | $62.16 | |
Emblem Health
| Professional | $55.95 | $62.16 | $62.16 |