| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $10.68 | $10.68 | $12.57 | |
Aetna
| Professional | $10.68 | $10.68 | $15.90 | |
Cigna
| Facility | $85.00 | $85.00 | $85.00 | |
Cigna
| Professional | $7.87 | $7.87 | $14.08 | |
United
| Professional | $12.57 | $12.57 | $18.21 |