| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $105.78 | $105.78 | $105.78 | |
Aetna
| Professional | $101.72 | $101.72 | $105.78 | |
Cigna
| Facility | $95.96 | $101.72 | $101.72 | |
Cigna
| Professional | $101.72 | $101.72 | $101.72 | |
United
| Professional | $101.72 | $101.72 | $101.72 |