| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $5,231.85 | $5,231.85 | $5,231.85 | |
Aetna
| Professional | $1,898.00 | $1,898.00 | $1,898.00 | |
Cigna
| Facility | $1,133.57 | $1,133.57 | $1,133.57 | |
Molina
| Professional | $2,703.12 | $2,842.64 | $2,842.64 | |
Providence
| Facility | $1,133.57 | $1,473.95 | $1,743.95 | |
Providence
| Professional | $1,839.87 | $2,110.17 | $2,424.09 | |
United
| Professional | $491.32 | $491.32 | $701.88 |