| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $87.10 | $87.10 | $87.10 | |
Aetna
| Professional | $64.57 | $77.62 | $102.33 | |
Cigna
| Professional | $25.70 | $52.48 | $186.21 | |
Molina
| Professional | $30.20 | $44.67 | $60.26 | |
United
| Professional | $40.74 | $52.48 | $77.62 |