| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $64.86 | $64.86 | $65.80 | |
Aetna
| Professional | $64.86 | $72.38 | $181.45 | |
Cigna
| Facility | $93.21 | $93.21 | $93.21 | |
Cigna
| Professional | $68.73 | $68.73 | $68.73 | |
United
| Professional | $72.38 | $94.00 | $164.34 |