| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $79.89 | $79.89 | $91.31 | |
Aetna
| Professional | $76.09 | $79.89 | $91.31 | |
Cigna
| Facility | $76.09 | $76.09 | $76.09 | |
Cigna
| Professional | $76.09 | $76.09 | $76.09 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 | |
United
| Professional | $72.29 | $76.09 | $98.92 |