| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $53.04 | $53.04 | $53.04 | |
Aetna
| Professional | $51.00 | $51.00 | $53.04 | |
Cigna
| Facility | $48.12 | $51.00 | $51.00 | |
Cigna
| Professional | $51.00 | $51.00 | $51.00 | |
United
| Professional | $51.00 | $51.00 | $51.00 |