| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $58.10 | $58.10 | $437.50 | |
Cigna
| Facility | $100.30 | $100.30 | $100.30 | |
Cigna
| Professional | $85.26 | $100.30 | $172.13 | |
Molina
| Professional | $53.52 | $94.17 | $149.30 | |
United
| Professional | $58.10 | $75.65 | $129.10 |