| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $19.95 | $26.92 | $77.62 | |
Cigna
| Facility | $34.67 | $34.67 | $34.67 | |
Cigna
| Professional | $25.70 | $25.70 | $25.70 | |
United
| Facility | $0.04 | $27.54 | $32.36 | |
United
| Professional | $27.54 | $32.36 | $45.71 |