| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $84.51 | $84.51 | $84.51 | |
Aetna
| Professional | $48.50 | $84.51 | $84.51 | |
Cigna
| Facility | $75.05 | $75.05 | $75.05 | |
Cigna
| Professional | $54.79 | $54.79 | $101.25 | |
United
| Professional | $38.54 | $55.19 | $100.99 |