| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $283.37 | $283.37 | $283.37 | |
Aetna
| Professional | $283.37 | $283.37 | $283.37 | |
Cigna
| Facility | $150.00 | $150.00 | $150.00 | |
Cigna
| Professional | $54.43 | $150.00 | $832.50 | |
Molina
| Professional | $60.00 | $60.00 | $60.00 | |
United
| Professional | $266.38 | $275.00 | $570.91 |