| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $575.00 | $731.00 | $1,013.00 | |
Aetna
| Professional | $743.44 | $1,006.33 | $1,278.03 | |
Cigna
| Facility | $750.00 | $750.00 | $750.00 | |
Molina
| Professional | $17.00 | $20.00 | $25.00 | |
United
| Professional | $684.31 | $980.57 | $1,811.41 |