| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $172.10 | $172.10 | $172.10 | |
Cigna
| Facility | $332.93 | $332.93 | $332.93 | |
Cigna
| Professional | $35.75 | $332.93 | $525.00 | |
Molina
| Professional | $158.39 | $279.32 | $442.83 | |
United
| Professional | $228.23 | $228.23 | $360.86 |