| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $74.41 | $74.41 | $74.41 | |
Aetna
| Professional | $71.55 | $71.55 | $74.41 | |
Cigna
| Facility | $67.50 | $71.55 | $71.55 | |
Cigna
| Professional | $71.55 | $71.55 | $71.55 | |
United
| Professional | $71.55 | $71.55 | $71.55 |