| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $72.06 | $72.06 | $529.77 | |
Cigna
| Facility | $115.51 | $115.51 | $151.61 | |
Cigna
| Professional | $98.18 | $115.51 | $205.50 | |
Molina
| Professional | $83.00 | $120.49 | $174.25 | |
United
| Professional | $72.06 | $86.74 | $160.15 |