| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1.00 | $1.00 | $1.00 | |
Aetna
| Professional | $1.00 | $1.00 | $1.00 | |
Cigna
| Facility | $64.00 | $64.00 | $64.00 | |
Cigna
| Professional | $232.10 | $232.10 | $232.10 | |
United
| Professional | $50.00 | $50.00 | $50.00 |