| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $14.65 | $14.65 | $106.92 | |
Aetna
| Professional | $14.44 | $14.65 | $16.34 | |
Cigna
| Professional | $11.39 | $17.57 | $35.60 | |
Medcost
| Facility | $14.65 | $14.80 | $23.73 | |
Medcost
| Professional | $56.56 | $56.56 | $56.56 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 | |
United
| Professional | $14.56 | $19.92 | $30.78 |