| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $76.09 | $76.09 | $76.09 | |
Aetna
| Professional | $76.09 | $76.09 | $91.31 | |
Cigna
| Facility | $76.09 | $76.09 | $76.09 | |
Cigna
| Professional | $76.09 | $76.09 | $76.09 | |
United
| Facility | $86.35 | $86.35 | $105.35 | |
United
| Professional | $66.20 | $76.09 | $77.61 |