| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $15.65 | $15.65 | $128.25 | |
Cigna
| Facility | $28.34 | $28.34 | $37.19 | |
Cigna
| Professional | $24.09 | $28.34 | $56.25 | |
Molina
| Professional | $17.60 | $25.61 | $36.99 | |
United
| Professional | $15.65 | $20.26 | $34.77 |