| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $42.29 | $42.29 | $49.78 | |
Aetna
| Professional | $42.29 | $50.65 | $61.97 | |
Cigna
| Professional | $52.82 | $67.70 | $98.18 | |
Medcost
| Facility | $42.29 | $50.75 | $82.64 | |
Medcost
| Professional | $65.63 | $65.63 | $65.63 | |
Molina
| Professional | $52.95 | $71.34 | $87.29 | |
United
| Professional | $54.28 | $67.06 | $99.46 |