| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $9.60 | $9.60 | $9.60 | |
Aetna
| Professional | $9.60 | $9.60 | $12.00 | |
Cigna
| Facility | $104.83 | $104.83 | $104.83 | |
Cigna
| Professional | $195.53 | $195.53 | $195.53 | |
United
| Professional | $79.29 | $79.29 | $79.29 |