| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $19.97 | $19.97 | $19.97 | |
Aetna
| Professional | $19.97 | $19.97 | $21.97 | |
Cigna
| Facility | $19.97 | $19.97 | $19.97 | |
Cigna
| Professional | $19.97 | $19.97 | $19.97 | |
United
| Professional | $16.97 | $19.97 | $20.97 |