| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $10.96 | $10.96 | $10.96 | |
Aetna
| Professional | $10.96 | $10.96 | $14.13 | |
Cigna
| Facility | $11.75 | $11.75 | $11.75 | |
Cigna
| Professional | $11.75 | $11.75 | $11.75 | |
United
| Facility | $11.48 | $12.02 | $14.79 | |
United
| Professional | $12.02 | $30.20 | $125.89 |