| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $415.00 | $415.00 | $415.00 | |
Aetna
| Professional | $415.00 | $415.00 | $415.00 | |
Cigna
| Professional | $432.81 | $432.81 | $432.81 | |
Molina
| Professional | $45.00 | $45.00 | $60.00 | |
United
| Professional | $500.00 | $500.00 | $500.00 |