| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $47.42 | $47.42 | $47.42 | |
Aetna
| Professional | $46.28 | $47.42 | $49.13 | |
Cigna
| Facility | $48.56 | $48.56 | $215.28 | |
Cigna
| Professional | $48.56 | $48.56 | $48.56 | |
Molina
| Professional | $30.00 | $45.00 | $64.20 | |
United
| Professional | $57.13 | $57.13 | $57.13 |