| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $562.50 | $1,125.00 | $2,250.00 | |
Aetna
| Professional | $562.50 | $900.00 | $900.00 | |
Cigna
| Facility | $487.50 | $487.50 | $487.50 | |
Cigna
| Professional | $861.93 | $861.93 | $1,077.41 | |
Molina
| Professional | $1,500.00 | $1,500.00 | $1,500.00 | |
Providence
| Facility | $487.50 | $712.50 | $900.00 | |
Providence
| Professional | $615.00 | $750.00 | $750.00 | |
United
| Professional | $315.00 | $315.00 | $450.00 |