| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $309.03 | $309.03 | $309.03 | |
Aetna
| Professional | $1,202.26 | $1,202.26 | $1,202.26 | |
Cigna
| Facility | $630.96 | $630.96 | $630.96 | |
Molina
| Professional | $39.81 | $39.81 | $50.12 | |
United
| Facility | $758.58 | $1,621.81 | $2,137.96 | |
Wellpoint
| Professional | $354.81 | $354.81 | $354.81 |