| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $102.33 | $120.23 | $120.23 | |
Aetna
| Professional | $97.72 | $100.00 | $120.23 | |
Cigna
| Facility | $194.98 | $194.98 | $194.98 | |
Cigna
| Professional | $11.75 | $549.54 | $549.54 | |
United
| Professional | $97.72 | $102.33 | $120.23 |