| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $239.18 | $2,538.00 | $2,538.00 | |
Aetna
| Professional | $239.19 | $239.19 | $313.83 | |
Cigna
| Professional | $561.67 | $561.67 | $561.67 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |