| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $517.29 | $517.29 | $550.00 | |
Aetna
| Professional | $517.29 | $517.29 | $605.00 | |
Cigna
| Facility | $177.27 | $236.35 | $408.88 | |
Molina
| Professional | $40.00 | $40.00 | $50.00 | |
Wellpoint
| Professional | $400.00 | $400.00 | $400.00 |