| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $70.06 | $70.06 | $70.06 | |
Cigna
| Facility | $112.00 | $112.73 | $112.73 | |
Cigna
| Professional | $15.59 | $112.73 | $221.25 | |
Molina
| Professional | $64.39 | $113.56 | $179.67 | |
United
| Professional | $70.06 | $84.23 | $155.69 |