| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $85.43 | $85.43 | $106.29 | |
Aetna
| Professional | $85.43 | $95.63 | $124.61 | |
Cigna
| Facility | $138.66 | $138.66 | $138.66 | |
Cigna
| Professional | $104.45 | $104.45 | $112.03 | |
United
| Professional | $104.45 | $130.16 | $176.34 |