| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $62.41 | $62.41 | $62.41 | |
Aetna
| Professional | $62.41 | $62.41 | $74.90 | |
Cigna
| Facility | $62.41 | $62.41 | $62.41 | |
Cigna
| Professional | $62.41 | $62.41 | $131.03 | |
United
| Professional | $54.30 | $62.41 | $74.89 |