| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $167.74 | $192.37 | $223.65 | |
Aetna
| Professional | $141.44 | $196.65 | $675.00 | |
Cigna
| Professional | $205.48 | $264.97 | $392.32 | |
Molina
| Professional | $142.89 | $187.02 | $232.57 | |
United
| Professional | $188.15 | $242.06 | $381.60 |