| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $512.10 | $512.10 | $512.10 | |
Aetna
| Professional | $512.10 | $512.10 | $512.10 | |
Cigna
| Facility | $578.29 | $578.29 | $578.29 | |
Cigna
| Professional | $59.82 | $578.29 | $866.25 | |
Molina
| Professional | $25.37 | $44.74 | $70.78 | |
United
| Professional | $47.09 | $76.19 | $927.00 |