| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $507.78 | $923.53 | $1,940.60 | |
Aetna
| Professional | $507.78 | $507.78 | $507.78 | |
Cigna
| Facility | $1,197.46 | $1,197.46 | $1,197.46 | |
Cigna
| Professional | $489.34 | $489.34 | $489.34 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |