| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $87.10 | $87.10 | $398.11 | |
Cigna
| Professional | $107.15 | $309.03 | $338.84 | |
Medcost
| Facility | $87.10 | $97.72 | $398.11 | |
Medcost
| Professional | $181.97 | $181.97 | $181.97 | |
Molina
| Professional | $30.20 | $30.20 | $30.20 | |
United
| Professional | $281.84 | $309.03 | $380.19 |