| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $321.44 | $321.44 | $321.44 | |
Aetna
| Professional | $321.44 | $321.44 | $321.44 | |
Cigna
| Facility | $370.80 | $370.80 | $370.80 | |
Cigna
| Professional | $57.24 | $370.80 | $862.50 | |
Molina
| Professional | $60.00 | $60.00 | $60.00 | |
United
| Professional | $316.58 | $316.58 | $500.55 |