| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $89.98 | $89.98 | $92.83 | |
Aetna
| Professional | $63.07 | $90.93 | $104.97 | |
Cigna
| Professional | $785.24 | $785.24 | $785.24 | |
Molina
| Professional | $17.00 | $25.00 | $50.00 | |
United
| Professional | $1,360.07 | $1,438.66 | $1,870.26 |