| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $13.77 | $13.77 | $13.77 | |
Aetna
| Professional | $12.96 | $13.77 | $13.77 | |
Cigna
| Facility | $13.25 | $13.25 | $64.00 | |
Cigna
| Professional | $13.25 | $13.25 | $14.58 | |
United
| Professional | $13.25 | $13.25 | $19.19 |