| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $75.55 | $75.55 | $75.55 | |
Aetna
| Professional | $72.88 | $75.55 | $125.63 | |
Cigna
| Facility | $75.55 | $75.55 | $75.55 | |
Cigna
| Professional | $75.55 | $75.55 | $119.43 | |
United
| Professional | $84.70 | $88.88 | $88.88 |