| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $7,799.00 | $9,062.00 | $21,886.00 | |
Aetna
| Professional | $3,520.23 | $3,520.23 | $3,520.23 | |
Cigna
| Facility | $890.00 | $890.00 | $890.00 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |