| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $34.49 | $34.49 | $2,985.99 | |
Aetna
| Professional | $33.33 | $34.49 | $34.49 | |
Cigna
| Facility | $69.03 | $69.03 | $69.03 | |
Cigna
| Professional | $2.02 | $2.02 | $2.02 | |
Medcost
| Facility | $31.66 | $34.49 | $46.56 | |
Medcost
| Professional | $20.00 | $20.00 | $20.00 | |
Molina
| Professional | $3,000.00 | $3,000.00 | $3,000.00 |