| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $35.28 | $35.28 | $35.28 | |
Aetna
| Professional | $33.92 | $33.92 | $35.28 | |
Cigna
| Facility | $32.00 | $33.92 | $33.92 | |
Cigna
| Professional | $33.92 | $33.92 | $33.92 | |
United
| Professional | $33.92 | $33.92 | $33.92 |