| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $46.55 | $46.55 | $46.55 | |
Aetna
| Professional | $45.02 | $45.84 | $49.61 | |
Cigna
| Facility | $26.11 | $26.11 | $26.11 | |
Cigna
| Professional | $60.98 | $76.68 | $112.83 | |
Medcost
| Facility | $40.35 | $41.23 | $60.52 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 | |
United
| Professional | $34.14 | $42.36 | $70.53 |