| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $93.11 | $93.11 | $93.11 | |
Cigna
| Facility | $123.98 | $123.98 | $126.46 | |
Cigna
| Professional | $17.16 | $123.98 | $251.25 | |
Molina
| Professional | $73.59 | $129.78 | $205.32 | |
United
| Professional | $97.01 | $97.01 | $153.38 |