| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $29.25 | $29.25 | $241.48 | |
Cigna
| Facility | $54.52 | $54.52 | $54.52 | |
Cigna
| Professional | $46.34 | $54.52 | $96.38 | |
Molina
| Professional | $37.60 | $54.59 | $78.85 | |
United
| Professional | $32.27 | $41.75 | $65.01 |