| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $40.64 | $213.40 | $421.14 | |
Aetna
| Professional | $40.65 | $40.65 | $42.69 | |
Cigna
| Facility | $40.65 | $40.65 | $40.65 | |
Cigna
| Professional | $40.65 | $40.65 | $40.65 | |
United
| Professional | $38.74 | $40.65 | $56.16 |