| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $87.57 | $87.57 | $300.00 | |
Cigna
| Professional | $107.80 | $322.00 | $512.00 | |
Medcost
| Facility | $46.20 | $96.33 | $245.00 | |
Medcost
| Professional | $46.20 | $56.25 | $245.00 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 | |
United
| Professional | $283.95 | $367.00 | $367.00 |