| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $63.10 | $79.43 | $79.43 | |
Cigna
| Professional | $26.30 | $26.30 | $26.30 | |
Medcost
| Facility | $66.07 | $79.43 | $91.20 | |
Molina
| Professional | $30.20 | $30.20 | $30.20 | |
United
| Professional | $16.98 | $30.20 | $123.03 |