| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $55.65 | $55.65 | $63.60 | |
Aetna
| Professional | $53.00 | $55.65 | $63.60 | |
Cigna
| Facility | $53.00 | $53.00 | $53.00 | |
Cigna
| Professional | $53.00 | $53.00 | $53.00 | |
Molina
| Professional | $17.00 | $20.00 | $25.00 | |
United
| Professional | $50.35 | $53.00 | $68.90 |