| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $89.41 | $89.41 | $89.41 | |
Aetna
| Professional | $89.41 | $89.41 | $98.35 | |
Cigna
| Facility | $89.41 | $89.41 | $89.41 | |
Cigna
| Professional | $89.41 | $89.41 | $89.41 | |
United
| Professional | $77.79 | $89.41 | $93.11 |