| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $30.75 | $30.75 | $34.13 | |
Aetna
| Professional | $30.75 | $30.75 | $34.13 | |
Cigna
| Facility | $25.75 | $25.75 | $25.75 | |
Molina
| Professional | $17.00 | $17.00 | $20.00 | |
United
| Professional | $24.28 | $24.28 | $28.65 |