| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $52.49 | $135.19 | $158.90 | |
Cigna
| Professional | $128.26 | $128.26 | $128.26 | |
Medcost
| Facility | $77.48 | $136.78 | $195.48 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 | |
United
| Professional | $121.97 | $148.91 | $278.02 |