| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $105.81 | $319.76 | $497.83 | |
Aetna
| Professional | $105.81 | $105.81 | $105.81 | |
Cigna
| Professional | $108.36 | $108.36 | $108.36 | |
Molina
| Professional | $45.00 | $60.00 | $243.83 | |
United
| Professional | $106.24 | $106.24 | $106.24 |