| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,638.91 | $9,693.32 | $16,647.05 | |
Aetna
| Professional | $2,216.90 | $6,090.55 | $10,076.21 | |
Cigna
| Professional | $1,326.50 | $1,326.50 | $1,326.50 | |
Molina
| Professional | $45.00 | $45.00 | $45.00 |