| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $80.06 | $80.06 | $80.06 | |
Aetna
| Professional | $80.06 | $80.06 | $126.61 | |
Cigna
| Facility | $64.00 | $64.00 | $64.00 | |
Cigna
| Professional | $101.34 | $101.34 | $101.34 | |
United
| Professional | $79.29 | $79.29 | $79.29 |