| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $18.62 | $18.62 | $18.62 | |
Aetna
| Professional | $4.87 | $4.87 | $4.87 | |
Cigna
| Facility | $4.87 | $4.87 | $4.87 | |
Cigna
| Professional | $4.87 | $4.87 | $4.87 | |
United
| Professional | $4.74 | $5.73 | $5.73 |