| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $160.30 | $160.30 | $1,401.22 | |
Cigna
| Facility | $229.50 | $229.50 | $229.50 | |
Cigna
| Professional | $195.08 | $229.50 | $562.50 | |
Molina
| Professional | $155.93 | $274.97 | $435.94 | |
United
| Professional | $160.30 | $223.10 | $356.22 |