| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $9.63 | $9.63 | $9.63 | |
Aetna
| Professional | $7.83 | $9.63 | $38.40 | |
Cigna
| Professional | $13.88 | $14.01 | $17.62 | |
Molina
| Professional | $30.05 | $36.26 | $2,500.00 | |
United
| Professional | $10.00 | $10.00 | $50.00 |