| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $50.72 | $50.72 | $50.72 | |
Aetna
| Professional | $50.72 | $50.72 | $55.79 | |
Cigna
| Facility | $50.71 | $50.71 | $50.71 | |
Cigna
| Professional | $50.71 | $50.71 | $154.54 | |
United
| Professional | $44.13 | $50.72 | $50.72 |