| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $41.83 | $41.83 | $41.83 | |
Aetna
| Professional | $41.83 | $41.83 | $41.83 | |
Cigna
| Facility | $21.86 | $25.72 | $25.72 | |
Cigna
| Professional | $21.86 | $21.86 | $21.86 | |
United
| Professional | $65.01 | $71.44 | $71.44 |