| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $13.33 | $40.42 | $137.74 | |
Cigna
| Professional | $19.00 | $25.50 | $27.78 | |
Medcost
| Facility | $14.51 | $113.03 | $145.06 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 | |
United
| Professional | $23.82 | $124.83 | $194.56 |