| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $102.80 | $102.80 | $102.80 | |
Aetna
| Professional | $97.96 | $102.80 | $102.80 | |
Cigna
| Facility | $102.80 | $102.80 | $102.80 | |
Cigna
| Professional | $102.80 | $102.80 | $102.80 | |
United
| Professional | $87.68 | $100.78 | $100.78 |