| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $183.16 | $381.53 | $1,307.71 | |
Aetna
| Professional | $176.54 | $183.16 | $187.57 | |
Cigna
| Facility | $131.81 | $161.40 | $215.20 | |
Cigna
| Professional | $187.57 | $187.57 | $187.57 | |
Molina
| Professional | $32.68 | $32.68 | $32.68 | |
Wellpoint
| Professional | $160.68 | $160.68 | $160.68 |