| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $62.25 | $62.25 | $62.25 | |
Aetna
| Professional | $57.50 | $63.83 | $77.54 | |
Cigna
| Facility | $84.06 | $84.06 | $84.06 | |
Cigna
| Professional | $66.06 | $66.06 | $346.12 | |
United
| Professional | $60.36 | $110.40 | $173.27 |