| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $11.45 | $11.45 | $11.45 | |
Aetna
| Professional | $11.45 | $14.22 | $124.16 | |
BCBS
| Professional | $50.00 | $50.00 | $50.00 | |
Cigna
| Professional | $19.00 | $20.00 | $31.32 | |
Molina
| Professional | $25.00 | $40.00 | $50.00 | |
United
| Professional | $23.82 | $122.45 | $213.61 |