| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $409.79 | $409.79 | $409.79 | |
Aetna
| Professional | $0.79 | $0.79 | $0.91 | |
Cigna
| Facility | $0.79 | $0.79 | $0.79 | |
Cigna
| Professional | $0.79 | $0.79 | $0.79 | |
United
| Professional | $0.75 | $0.84 | $1.18 |