| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $89.95 | $89.95 | $89.95 | |
Aetna
| Professional | $76.31 | $89.95 | $141.66 | |
BCBS
| Professional | $153.54 | $153.54 | $153.54 | |
Cigna
| Professional | $60.00 | $73.59 | $113.50 | |
Molina
| Professional | $17.00 | $21.25 | $50.00 | |
United
| Professional | $71.89 | $93.18 | $142.10 |