| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $262.77 | $262.77 | $262.77 | |
Cigna
| Facility | $128.00 | $128.00 | $128.00 | |
Cigna
| Professional | $108.80 | $128.00 | $348.75 | |
Molina
| Professional | $31.89 | $291.61 | $505.46 | |
United
| Professional | $372.27 | $402.32 | $636.13 |