| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $307.00 | $307.00 | $307.00 | |
Cigna
| Facility | $525.00 | $525.00 | $525.00 | |
Molina
| Professional | $40.00 | $40.00 | $50.00 | |
United
| Professional | $584.79 | $584.79 | $584.79 | |
Wellpoint
| Professional | $354.09 | $354.09 | $354.09 |