| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $61.66 | $61.66 | $61.66 | |
Aetna
| Professional | $61.66 | $61.66 | $85.11 | |
Cigna
| Facility | $63.10 | $63.10 | $63.10 | |
Cigna
| Professional | $63.10 | $63.10 | $63.10 | |
United
| Facility | $63.10 | $63.10 | $93.33 | |
United
| Professional | $60.26 | $81.28 | $125.89 |