| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $26.94 | $26.94 | $26.94 | |
Aetna
| Professional | $26.94 | $26.94 | $29.93 | |
Cigna
| Facility | $26.94 | $26.94 | $26.94 | |
Cigna
| Professional | $26.94 | $26.94 | $56.61 | |
United
| Professional | $23.44 | $26.94 | $32.33 |