| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $100.80 | $100.80 | $100.80 | |
Aetna
| Professional | $37.50 | $56.10 | $109.25 | |
Cigna
| Facility | $51.82 | $51.82 | $51.82 | |
Cigna
| Professional | $38.22 | $38.22 | $38.22 | |
United
| Professional | $36.40 | $57.20 | $77.50 |