| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $115.31 | $115.31 | $115.31 | |
Aetna
| Professional | $28.38 | $28.38 | $30.16 | |
Cigna
| Facility | $30.08 | $30.08 | $30.08 | |
Cigna
| Professional | $30.08 | $30.08 | $30.08 | |
United
| Professional | $28.21 | $30.08 | $30.08 |