| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $258.58 | $258.58 | $258.58 | |
Aetna
| Professional | $255.05 | $269.77 | $300.63 | |
Cigna
| Professional | $22.70 | $22.70 | $22.70 | |
Molina
| Professional | $30.00 | $30.00 | $60.00 | |
United
| Professional | $258.47 | $339.90 | $339.90 |