| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $87.98 | $87.98 | $87.98 | |
Aetna
| Professional | $87.98 | $87.98 | $105.57 | |
Cigna
| Facility | $87.98 | $87.98 | $87.98 | |
Cigna
| Professional | $87.98 | $87.98 | $87.98 | |
United
| Professional | $74.78 | $87.98 | $87.98 |