| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $147.91 | $147.91 | $213.80 | |
Aetna
| Professional | $144.54 | $147.91 | $181.97 | |
Cigna
| Facility | $151.36 | $151.36 | $151.36 | |
Cigna
| Professional | $151.36 | $151.36 | $151.36 | |
Molina
| Professional | $21.38 | $25.12 | $30.20 | |
United
| Professional | $123.03 | $169.82 | $186.21 |