| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $14.90 | $14.90 | $14.90 | |
Aetna
| Professional | $14.55 | $14.55 | $14.90 | |
Cigna
| Facility | $62.05 | $62.05 | $62.05 | |
Cigna
| Professional | $62.05 | $62.05 | $62.05 | |
United
| Professional | $57.09 | $62.05 | $65.15 |