| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $11.98 | $14.00 | $18.10 | |
Cigna
| Professional | $10.00 | $15.00 | $20.83 | |
Medcost
| Facility | $4.98 | $12.12 | $17.50 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 | |
United
| Professional | $4.13 | $5.30 | $12.47 |