| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $12.66 | $12.66 | $12.66 | |
Aetna
| Professional | $9.46 | $12.66 | $15.74 | |
Cigna
| Facility | $85.00 | $85.00 | $85.00 | |
Cigna
| Professional | $13.47 | $13.47 | $13.47 | |
Medcost
| Facility | $12.66 | $17.26 | $26.84 | |
Medcost
| Professional | $10.11 | $10.11 | $10.11 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 | |
United
| Professional | $6.42 | $9.64 | $13.99 |