| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $132.97 | $132.97 | $132.97 | |
Aetna
| Professional | $132.97 | $132.97 | $132.97 | |
Cigna
| Facility | $178.86 | $178.86 | $178.86 | |
Cigna
| Professional | $20.14 | $152.03 | $379.69 | |
Molina
| Professional | $13.52 | $13.52 | $60.00 | |
United
| Professional | $110.44 | $140.86 | $214.20 |