| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $47.19 | $47.19 | $47.19 | |
Aetna
| Professional | $11.62 | $11.62 | $12.34 | |
Cigna
| Facility | $14.52 | $14.52 | $14.52 | |
Cigna
| Professional | $14.52 | $14.52 | $14.52 | |
United
| Professional | $14.52 | $14.52 | $14.96 |