| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $1.00 | $9.55 | $10.00 | |
Cigna
| Facility | $64.57 | $64.57 | $64.57 | |
Cigna
| Professional | $10.72 | $10.72 | $10.72 | |
Medcost
| Facility | $2.34 | $23.99 | $42.66 | |
Molina
| Professional | $30.20 | $30.20 | $30.20 | |
United
| Professional | $19.50 | $23.99 | $40.74 |