| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $143.10 | $143.10 | $143.10 | |
Aetna
| Professional | $126.42 | $143.10 | $182.63 | |
Cigna
| Facility | $147.10 | $147.10 | $147.10 | |
Cigna
| Professional | $107.38 | $125.04 | $147.10 | |
Molina
| Professional | $12.01 | $16.30 | $28.08 | |
United
| Professional | $11.78 | $12.09 | $60.87 |