| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $532.04 | $532.04 | $532.04 | |
Aetna
| Professional | $532.04 | $532.04 | $1,276.22 | |
Cigna
| Facility | $109.87 | $109.87 | $109.87 | |
Cigna
| Professional | $93.39 | $109.87 | $147.10 | |
Molina
| Professional | $66.20 | $128.14 | $184.41 | |
United
| Professional | $74.41 | $82.40 | $780.36 |