| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $95.20 | $95.20 | $95.20 | |
Aetna
| Professional | $91.54 | $91.54 | $95.20 | |
Cigna
| Facility | $86.36 | $91.54 | $91.54 | |
Cigna
| Professional | $91.54 | $91.54 | $91.54 | |
United
| Professional | $91.54 | $91.54 | $91.54 |