| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $68.04 | $68.04 | $68.04 | |
Aetna
| Professional | $68.04 | $68.04 | $68.04 | |
Cigna
| Professional | $10.52 | $98.98 | $192.19 | |
Molina
| Professional | $4.34 | $7.65 | $12.14 | |
United
| Professional | $50.45 | $50.45 | $109.69 |