| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $29.99 | $29.99 | $262.82 | |
Cigna
| Facility | $44.10 | $44.10 | $44.10 | |
Cigna
| Professional | $37.49 | $44.10 | $105.00 | |
Molina
| Professional | $40.74 | $59.14 | $85.43 | |
United
| Professional | $29.99 | $42.50 | $66.65 |