| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $45.30 | $67.77 | $102.81 | |
Cigna
| Facility | $63.99 | $63.99 | $63.99 | |
Cigna
| Professional | $23.06 | $27.62 | $268.18 | |
Medcost
| Facility | $45.30 | $53.65 | $95.85 | |
Medcost
| Professional | $53.65 | $53.65 | $54.34 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 | |
United
| Professional | $78.08 | $95.12 | $150.86 |