| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $785.65 | $785.65 | $982.06 | |
Aetna
| Professional | $785.65 | $1,046.84 | $1,151.54 | |
Cigna
| Facility | $99.01 | $99.01 | $99.01 | |
Molina
| Professional | $60.00 | $85.00 | $1,500.00 | |
Providence
| Facility | $99.01 | $99.01 | $758.75 |