| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $430.60 | $430.60 | $430.60 | |
Aetna
| Professional | $415.04 | $430.60 | $446.17 | |
Cigna
| Professional | $440.98 | $440.98 | $440.98 | |
Molina
| Professional | $30.00 | $411.55 | $506.52 |