| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $48.56 | $48.56 | $48.56 | |
Aetna
| Professional | $45.70 | $48.56 | $48.56 | |
Cigna
| Facility | $48.56 | $48.56 | $48.56 | |
Cigna
| Professional | $48.56 | $48.56 | $48.56 | |
United
| Professional | $57.13 | $57.13 | $57.13 |