| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $24.11 | $35.28 | $35.28 | |
Aetna
| Professional | $24.11 | $24.40 | $35.28 | |
Cigna
| Facility | $24.50 | $24.50 | $26.95 | |
Cigna
| Professional | $24.50 | $24.50 | $24.50 | |
Molina
| Professional | $17.00 | $17.00 | $20.00 | |
United
| Professional | $28.22 | $29.40 | $38.22 |