| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $77.70 | $77.70 | $77.70 | |
Aetna
| Professional | $35.88 | $77.70 | $128.10 | |
Cigna
| Professional | $38.22 | $38.22 | $38.22 | |
Molina
| Professional | $17.00 | $25.00 | $50.00 | |
United
| Professional | $44.20 | $59.00 | $95.06 |