| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $22.50 | $22.50 | $22.50 | |
Aetna
| Professional | $5.12 | $23.32 | $36.47 | |
BCBS
| Professional | $125.00 | $125.00 | $125.00 | |
Cigna
| Professional | $19.00 | $20.00 | $31.32 | |
Molina
| Professional | $25.00 | $30.26 | $50.00 | |
United
| Facility | $78.18 | $78.18 | $88.20 | |
United
| Professional | $5.08 | $8.16 | $23.82 |