| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $69.17 | $84.29 | $102.99 | |
Cigna
| Facility | $113.46 | $113.46 | $113.46 | |
Cigna
| Professional | $87.23 | $118.58 | $190.95 | |
Medcost
| Facility | $75.33 | $116.02 | $190.65 | |
Medcost
| Professional | $86.24 | $140.00 | $171.00 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 | |
United
| Professional | $86.16 | $106.73 | $158.72 |