| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $327.64 | $327.64 | $327.64 | |
Cigna
| Facility | $407.96 | $407.96 | $407.96 | |
Cigna
| Professional | $64.33 | $407.96 | $933.75 | |
Molina
| Professional | $267.98 | $472.57 | $749.20 | |
United
| Professional | $327.64 | $400.44 | $728.08 |