| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $78.17 | $78.17 | $78.17 | |
Aetna
| Professional | $78.17 | $78.17 | $85.99 | |
Cigna
| Facility | $78.17 | $78.17 | $78.17 | |
Cigna
| Professional | $78.17 | $78.17 | $78.17 | |
United
| Professional | $70.34 | $78.17 | $78.17 |