| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $331.13 | $416.87 | $9,772.37 | |
Medcost
| Professional | $141.25 | $141.25 | $3,715.35 | |
Medcost
| Facility | $107.15 | $363.08 | $3,801.89 | |
Molina
| Professional | $30.20 | $30.20 | $30.20 |