| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $58.10 | $64.61 | $76.59 | |
Cigna
| Facility | $83.52 | $83.52 | $83.52 | |
Cigna
| Professional | $74.86 | $89.40 | $143.90 | |
Medcost
| Facility | $61.98 | $82.02 | $126.38 | |
Medcost
| Professional | $82.02 | $82.02 | $183.86 | |
Molina
| Professional | $35.00 | $35.00 | $56.40 | |
United
| Professional | $63.23 | $78.69 | $124.33 |