| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $45.71 | $56.23 | $295.12 | |
Cigna
| Facility | $89.13 | $89.13 | $89.13 | |
Cigna
| Professional | $64.57 | $64.57 | $64.57 | |
United
| Facility | $0.10 | $79.43 | $91.20 | |
United
| Professional | $54.95 | $66.07 | $93.33 |