| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $95.55 | $95.55 | $95.55 | |
Aetna
| Professional | $23.52 | $23.52 | $24.99 | |
Cigna
| Facility | $24.50 | $24.50 | $24.50 | |
Cigna
| Professional | $24.50 | $24.50 | $24.50 | |
United
| Professional | $16.77 | $29.40 | $29.40 |