| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $64.00 | $64.00 | $64.00 | |
Cigna
| Professional | $6.35 | $6.35 | $6.35 | |
Molina
| Professional | $40.00 | $40.00 | $50.00 | |
United
| Professional | $570.00 | $570.00 | $570.00 | |
Wellpoint
| Professional | $750.00 | $750.00 | $750.00 |