| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $7.76 | $13.45 | $20.69 | |
Aetna
| Professional | 25 | $86.20 | $86.20 | $86.20 |
Aetna
| Professional | 52 | $3.74 | $5.41 | $9.48 |
Cigna
| Professional | $15.77 | $15.77 | $18.96 | |
United
| Professional | $14.96 | $19.11 | $41.14 |