| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $38.54 | $38.54 | $38.54 | |
Aetna
| Professional | $38.54 | $38.54 | $46.25 | |
Cigna
| Facility | $38.54 | $38.54 | $38.54 | |
Cigna
| Professional | $38.54 | $38.54 | $75.88 | |
United
| Professional | $33.53 | $38.54 | $46.25 |