| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $328.38 | $328.38 | $328.38 | |
Cigna
| Facility | $200.00 | $200.00 | $200.00 | |
Cigna
| Professional | $170.00 | $200.00 | $551.25 | |
Molina
| Professional | $38.10 | $518.34 | $898.46 | |
United
| Professional | $380.64 | $502.80 | $815.82 |