| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $110.87 | $110.87 | $765.62 | |
Cigna
| Facility | $160.96 | $160.96 | $215.49 | |
Cigna
| Professional | $136.82 | $160.96 | $274.13 | |
Molina
| Professional | $113.17 | $164.64 | $237.30 | |
United
| Professional | $110.87 | $125.95 | $246.37 |