| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $30.95 | $30.95 | $218.71 | |
Cigna
| Facility | $48.69 | $48.69 | $48.69 | |
Cigna
| Professional | $41.39 | $48.69 | $86.63 | |
Molina
| Professional | $26.33 | $46.44 | $73.47 | |
United
| Professional | $30.95 | $37.82 | $68.77 |