| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $170.95 | $170.95 | $170.95 | |
Aetna
| Professional | $170.95 | $170.95 | $170.95 | |
Cigna
| Professional | $306.00 | $306.00 | $306.00 | |
Molina
| Professional | $45.00 | $45.00 | $60.00 | |
United
| Professional | $285.00 | $300.00 | $300.00 |