| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,737.80 | $1,737.80 | $1,737.80 | |
Aetna
| Professional | $1,148.15 | $1,737.80 | $3,162.28 | |
Cigna
| Facility | $1,202.26 | $1,202.26 | $1,202.26 | |
Molina
| Professional | $30.20 | $30.20 | $30.20 | |
United
| Facility | $575.44 | $1,348.96 | $1,995.26 |