| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $207.72 | $207.72 | $207.72 | |
Aetna
| Professional | $207.72 | $207.72 | $207.72 | |
Cigna
| Facility | $338.00 | $338.00 | $338.00 | |
Cigna
| Professional | $41.13 | $338.00 | $618.75 | |
Molina
| Professional | $60.00 | $60.00 | $60.00 | |
United
| Professional | $195.27 | $212.83 | $418.58 |