| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $139.66 | $139.66 | $139.66 | |
Cigna
| Facility | $172.77 | $172.77 | $172.77 | |
Cigna
| Professional | $36.07 | $172.77 | $592.50 | |
Molina
| Professional | $173.25 | $305.53 | $484.38 | |
United
| Professional | $139.66 | $214.81 | $310.37 |