| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $26.18 | $2,378.27 | $3,480.48 | |
Aetna
| Professional | $26.18 | $137.47 | $529.04 | |
Cigna
| Professional | $165.00 | $165.00 | $165.00 | |
Molina
| Professional | $30.00 | $45.00 | $75.00 |