| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $46.77 | $46.77 | $46.77 | |
Aetna
| Professional | $46.77 | $47.72 | $65.29 | |
Cigna
| Facility | $75.05 | $75.05 | $108.90 | |
Cigna
| Professional | $54.79 | $54.79 | $416.30 | |
United
| Professional | $49.55 | $70.45 | $133.12 |