| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $198.44 | $198.44 | $290.39 | |
Aetna
| Professional | $193.60 | $205.70 | $290.39 | |
Cigna
| Facility | $205.70 | $205.70 | $205.70 | |
Cigna
| Professional | $205.70 | $205.70 | $205.70 | |
Molina
| Professional | $38.25 | $45.00 | $50.00 | |
United
| Professional | $209.00 | $220.00 | $286.00 |