| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $71.55 | $71.55 | $71.55 | |
Aetna
| Professional | $71.55 | $71.55 | $83.00 | |
Cigna
| Facility | $71.55 | $71.55 | $71.55 | |
Cigna
| Professional | $71.55 | $71.55 | $71.55 | |
United
| Professional | $62.25 | $71.55 | $85.86 |