| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $81.28 | $107.15 | $138.04 | |
Ambetter
| Professional | $120.23 | $120.23 | $120.23 | |
Cigna
| Professional | $89.13 | $89.13 | $89.13 | |
Medica
| Professional | $89.13 | $131.83 | $1,000.00 | |
United
| Professional | $87.10 | $128.82 | $190.55 |