| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $12.65 | $12.65 | $113.26 | |
Cigna
| Facility | $28.37 | $28.37 | $28.37 | |
Cigna
| Professional | $24.11 | $28.37 | $51.75 | |
Molina
| Professional | $20.98 | $30.45 | $43.99 | |
United
| Professional | $12.65 | $19.57 | $28.10 |