| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $19.27 | $19.27 | $166.66 | |
Cigna
| Facility | $37.90 | $37.90 | $37.90 | |
Cigna
| Professional | $32.22 | $37.90 | $67.13 | |
Molina
| Professional | $25.96 | $35.13 | $54.99 | |
United
| Professional | $19.27 | $28.82 | $44.16 |