| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $93.33 | $2,570.40 | $12,302.69 | |
Aetna
| Professional | $3,801.89 | $5,128.61 | $16,218.10 | |
Cigna
| Professional | $3,467.37 | $3,467.37 | $3,467.37 | |
Molina
| Professional | $30.20 | $30.20 | $60.26 |