| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $65.50 | $127.55 | $250.54 | |
Aetna
| Professional | $113.00 | $127.55 | $144.90 | |
Cigna
| Facility | $102.87 | $134.47 | $134.47 | |
Cigna
| Professional | $134.47 | $134.47 | $134.47 | |
Molina
| Professional | $17.00 | $17.00 | $20.00 | |
United
| Professional | $120.06 | $133.38 | $141.66 |