| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $63.34 | $63.34 | $63.34 | |
Aetna
| Professional | $32.67 | $63.34 | $96.73 | |
Cigna
| Professional | $21.97 | $27.62 | $95.01 | |
Molina
| Professional | $38.25 | $45.00 | $70.00 | |
United
| Professional | $40.15 | $72.29 | $114.75 |