| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $39.81 | $57.54 | $1,096.48 | |
Aetna
| Professional | $34.67 | $44.67 | $1,202.26 | |
Cigna
| Professional | $707.95 | $831.76 | $1,202.26 | |
Molina
| Professional | $933.25 | $933.25 | $933.25 | |
United
| Professional | $39.81 | $50.12 | $60.26 |