| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $67.26 | $67.27 | $67.27 | |
Aetna
| Professional | $67.27 | $67.27 | $80.73 | |
Cigna
| Facility | $67.27 | $67.27 | $67.27 | |
Cigna
| Professional | $67.27 | $67.27 | $67.27 | |
United
| Professional | $58.52 | $67.27 | $67.27 |