| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $736.18 | $736.18 | $736.18 | |
Aetna
| Professional | $736.18 | $736.18 | $736.18 | |
Cigna
| Professional | $876.07 | $876.07 | $876.07 | |
Molina
| Professional | $45.00 | $60.00 | $996.49 | |
United
| Professional | $842.61 | $886.96 | $886.96 |