| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $561.74 | $561.74 | $561.74 | |
Aetna
| Professional | $561.74 | $561.74 | $561.74 | |
Cigna
| Professional | $358.29 | $358.29 | $358.29 | |
Molina
| Professional | $45.00 | $60.00 | $485.12 | |
United
| Professional | $676.80 | $676.80 | $676.80 |