| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $12.88 | $12.88 | $32.36 | |
Aetna
| Professional | $12.02 | $12.88 | $15.85 | |
Cigna
| Facility | $13.18 | $13.18 | $52.48 | |
Cigna
| Professional | $13.18 | $13.18 | $16.22 | |
Molina
| Professional | $13.18 | $30.20 | $70.79 | |
United
| Professional | $13.18 | $13.18 | $13.18 |