| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $1,584.89 | $1,905.46 | $2,290.87 | |
Medcost
| Professional | $741.31 | $741.31 | $831.76 | |
Medcost
| Facility | $512.86 | $676.08 | $1,096.48 | |
Molina
| Professional | $30.20 | $30.20 | $30.20 |