| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $791.41 | $791.41 | $791.41 | |
Aetna
| Professional | $791.41 | $791.41 | $928.59 | |
Cigna
| Professional | $271.26 | $271.26 | $271.26 | |
Molina
| Professional | $60.00 | $60.00 | $85.00 | |
Providence
| Facility | $791.41 | $791.41 | $1,028.83 | |
Providence
| Professional | $271.26 | $271.26 | $2,250,000.00 |