| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $389.52 | $389.52 | $389.52 | |
Cigna
| Facility | $450.00 | $450.00 | $450.00 | |
Cigna
| Professional | $97.68 | $450.00 | $1,410.00 | |
Molina
| Professional | $410.61 | $724.09 | $1,147.95 | |
United
| Professional | $366.15 | $598.94 | $784.59 |