| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $72.44 | $85.11 | $85.11 | |
Aetna
| Professional | $72.44 | $72.44 | $100.00 | |
Ambetter
| Professional | $63.10 | $74.13 | $93.33 | |
Cigna
| Facility | $93.33 | $93.33 | $93.33 | |
Cigna
| Professional | $93.33 | $93.33 | $93.33 | |
United
| Professional | $81.28 | $93.33 | $100.00 |