| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $22.97 | $22.97 | $22.97 | |
Aetna
| Professional | $22.43 | $22.97 | $22.97 | |
Cigna
| Facility | $22.97 | $22.97 | $85.00 | |
Cigna
| Professional | $22.97 | $22.97 | $34.32 | |
United
| Professional | $22.52 | $22.52 | $27.02 |