| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $86.22 | $141.88 | $268.16 | |
Cigna
| Professional | $128.49 | $128.49 | $128.49 | |
Molina
| Professional | $30.00 | $60.00 | $259.00 | |
United
| Professional | $104.57 | $133.55 | $201.17 |