| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $318.83 | $318.83 | $318.83 | |
Aetna
| Professional | $318.83 | $318.83 | $318.83 | |
Cigna
| Facility | $255.74 | $255.74 | $255.74 | |
Cigna
| Professional | $56.76 | $255.74 | $840.00 | |
Molina
| Professional | $60.00 | $60.00 | $60.00 | |
United
| Professional | $299.64 | $337.64 | $524.02 |