| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $42.97 | $42.97 | $418.93 | |
Cigna
| Facility | $57.76 | $57.76 | $57.76 | |
Cigna
| Professional | $49.10 | $57.76 | $154.50 | |
Molina
| Professional | $60.00 | $60.00 | $60.00 | |
United
| Professional | $42.97 | $66.56 | $95.49 |