| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $906.54 | $906.54 | $906.54 | |
Cigna
| Professional | $486.32 | $510.39 | $611.51 | |
Molina
| Professional | $40.00 | $40.00 | $50.00 | |
United
| Professional | $192.50 | $218.43 | $259.10 | |
Wellpoint
| Professional | $10.00 | $10.00 | $431.83 |