| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $100.14 | $100.14 | $204.84 | |
Aetna
| Professional | $76.50 | $100.14 | $125.18 | |
Cigna
| Facility | $73.81 | $106.62 | $106.62 | |
Cigna
| Professional | $106.62 | $106.62 | $106.62 | |
Molina
| Professional | $20.00 | $70.81 | $78.68 | |
United
| Professional | $96.60 | $105.77 | $115.46 |