| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $100.84 | $100.84 | $640.77 | |
Cigna
| Facility | $123.59 | $123.59 | $123.59 | |
Cigna
| Professional | $105.05 | $123.59 | $222.38 | |
Molina
| Professional | $60.00 | $105.32 | $166.62 | |
United
| Professional | $95.59 | $100.84 | $224.08 |