| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $28.18 | $28.18 | $28.18 | |
Aetna
| Professional | $19.05 | $28.18 | $38.02 | |
Cigna
| Professional | $19.05 | $19.05 | $19.05 | |
Select Health
| Professional | $25.12 | $38.02 | $38.02 | |
United
| Professional | $28.18 | $37.15 | $58.88 |