| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $30.20 | $30.20 | $281.84 | |
Aetna
| Professional | $30.20 | $44.67 | $630.96 | |
Cigna
| Professional | $263.03 | $398.11 | $758.58 | |
Medcost
| Facility | $50.12 | $2,570.40 | $5,623.41 | |
Molina
| Professional | $114.82 | $363.08 | $602.56 | |
United
| Professional | $42.66 | $58.88 | $79.43 |