| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $9.10 | $9.10 | $9.10 | |
Aetna
| Professional | $9.10 | $14.66 | $29.56 | |
Cigna
| Professional | $8.38 | $8.38 | $8.38 | |
Molina
| Professional | $8.46 | $30.00 | $45.00 | |
United
| Professional | $15.00 | $15.00 | $23.15 |