| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $45.71 | $52.48 | $190.55 | |
Cigna
| Facility | $75.86 | $75.86 | $75.86 | |
Cigna
| Professional | $56.23 | $56.23 | $56.23 | |
United
| Facility | $0.11 | $70.79 | $75.86 | |
United
| Professional | $70.79 | $83.18 | $117.49 |