| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $402.32 | $6,022.64 | $6,602.65 | |
Aetna
| Professional | $402.32 | $402.32 | $4,972.50 | |
Cigna
| Professional | $1,054.93 | $1,054.93 | $1,054.93 | |
Molina
| Professional | $45.00 | $45.00 | $45.00 |