| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $51.29 | $57.54 | $288.40 | |
Cigna
| Facility | $100.00 | $100.00 | $100.00 | |
Cigna
| Professional | $72.44 | $72.44 | $72.44 | |
United
| Facility | $0.10 | $83.18 | $93.33 | |
United
| Professional | $56.23 | $67.61 | $104.71 |