| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $79.00 | $79.00 | $192.78 | |
Cigna
| Facility | $110.00 | $110.00 | $112.20 | |
Cigna
| Professional | $13.15 | $93.50 | $234.38 | |
Molina
| Professional | $60.00 | $95.24 | $150.69 | |
United
| Professional | $73.62 | $79.00 | $175.56 |