| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $437.50 | $437.50 | $437.50 | |
Cigna
| Facility | $833.40 | $833.40 | $833.40 | |
Cigna
| Professional | $106.49 | $833.40 | $1,571.25 | |
Molina
| Professional | $459.90 | $809.29 | $1,283.02 | |
United
| Professional | $437.50 | $668.58 | $972.22 |