| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $449.37 | $449.37 | $449.37 | |
Aetna
| Professional | $449.37 | $449.37 | $449.37 | |
Cigna
| Professional | $59.64 | $577.92 | $1,082.81 | |
Molina
| Professional | $60.00 | $60.00 | $60.00 | |
United
| Professional | $422.42 | $460.52 | $905.33 |