| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $69.34 | $7,799.00 | $21,886.00 | |
Aetna
| Professional | $69.34 | $72.37 | $78.91 | |
Cigna
| Facility | $33.06 | $33.06 | $33.06 | |
Medcost
| Facility | $69.34 | $70.94 | $93.62 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 | |
United
| Professional | $63.81 | $75.77 | $117.10 |