| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $177.95 | $177.95 | $177.95 | |
Aetna
| Professional | $173.66 | $177.95 | $184.38 | |
Cigna
| Facility | $182.24 | $182.24 | $182.24 | |
Cigna
| Professional | $182.24 | $182.24 | $182.24 | |
Molina
| Professional | $75.00 | $220.38 | $240.88 |