| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $190.67 | $190.67 | $190.67 | |
Aetna
| Professional | $190.67 | $190.67 | $190.67 | |
Cigna
| Professional | $40.57 | $40.57 | $745.31 | |
Molina
| Professional | $60.00 | $60.00 | $60.00 | |
United
| Professional | $23.72 | $25.54 | $299.04 |