| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $57.57 | $57.57 | $380.07 | |
Cigna
| Facility | $81.17 | $81.17 | $81.17 | |
Cigna
| Professional | $68.98 | $81.17 | $144.38 | |
Molina
| Professional | $56.50 | $75.49 | $119.43 | |
United
| Professional | $57.57 | $61.50 | $127.93 |