| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $53.00 | $53.00 | $53.00 | |
Aetna
| Professional | $53.00 | $53.00 | $63.60 | |
Cigna
| Facility | $53.00 | $53.00 | $53.00 | |
Cigna
| Professional | $53.00 | $53.00 | $53.00 | |
United
| Professional | $45.05 | $53.00 | $53.00 |