| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $68.81 | $68.81 | $68.81 | |
Aetna
| Professional | $43.47 | $68.81 | $113.46 | |
Cigna
| Professional | $45.92 | $45.92 | $45.92 | |
Molina
| Professional | $17.00 | $25.00 | $50.00 | |
United
| Professional | $53.55 | $70.80 | $109.54 |