| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $51.80 | $51.80 | $51.80 | |
Aetna
| Professional | $10.35 | $51.80 | $85.40 | |
Cigna
| Professional | $11.55 | $11.55 | $11.55 | |
Molina
| Professional | $17.00 | $25.00 | $50.00 | |
United
| Professional | $12.75 | $17.21 | $26.08 |