| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $30.20 | $30.20 | $645.65 | |
Aetna
| Professional | $30.20 | $44.67 | $1,445.44 | |
Cigna
| Professional | $645.65 | $1,000.00 | $1,905.46 | |
Medcost
| Facility | $50.12 | $2,570.40 | $5,623.41 | |
Molina
| Professional | $288.40 | $912.01 | $1,513.56 | |
United
| Professional | $42.66 | $58.88 | $79.43 |