| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $11.88 | $11.88 | $11.88 | |
Aetna
| Professional | $11.88 | $11.88 | $13.58 | |
Cigna
| Facility | $11.88 | $11.88 | $11.88 | |
Cigna
| Professional | $11.88 | $11.88 | $20.50 | |
United
| Professional | $10.34 | $11.88 | $13.02 |