| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $85.51 | $85.51 | $85.51 | |
Aetna
| Professional | $21.05 | $21.05 | $22.36 | |
Cigna
| Facility | $21.05 | $21.05 | $21.05 | |
Cigna
| Professional | $21.05 | $21.05 | $21.05 | |
United
| Professional | $21.05 | $21.05 | $26.31 |