| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $7.08 | $4,570.88 | $12,022.64 | |
Aetna
| Professional | $3,388.44 | $3,890.45 | $3,890.45 | |
Cigna
| Professional | $1,318.26 | $1,318.26 | $1,318.26 | |
Molina
| Professional | $30.20 | $30.20 | $30.20 |