| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $46.49 | $46.49 | $46.49 | |
Aetna
| Professional | $46.49 | $46.49 | $46.49 | |
Cigna
| Facility | $49.22 | $49.22 | $49.22 | |
Cigna
| Professional | $49.22 | $49.22 | $68.44 | |
Molina
| Professional | $45.00 | $45.00 | $60.00 | |
United
| Professional | $15.41 | $16.22 | $16.22 |