| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $98.11 | $98.11 | $98.11 | |
Aetna
| Professional | $98.11 | $98.11 | $117.73 | |
Cigna
| Facility | $98.11 | $98.11 | $98.11 | |
Cigna
| Professional | $98.11 | $98.11 | $98.11 | |
United
| Professional | $85.36 | $98.11 | $98.11 |