| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $50.00 | $50.00 | $50.00 | |
Aetna
| Professional | $50.00 | $50.00 | $50.00 | |
Cigna
| Facility | $493.74 | $493.74 | $493.74 | |
Cigna
| Professional | $38.77 | $38.77 | $38.77 | |
United
| Professional | $50.00 | $50.00 | $50.00 |