| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $147.60 | $147.60 | $216.00 | |
Aetna
| Professional | $144.00 | $153.00 | $216.00 | |
Cigna
| Facility | $153.00 | $153.00 | $153.00 | |
Cigna
| Professional | $153.00 | $153.00 | $153.00 | |
Molina
| Professional | $17.00 | $20.00 | $25.00 | |
United
| Professional | $171.00 | $180.00 | $234.00 |