| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $273.51 | $273.51 | $273.51 | |
Aetna
| Professional | $273.51 | $273.51 | $273.51 | |
Cigna
| Facility | $316.74 | $316.74 | $316.74 | |
Cigna
| Professional | $52.19 | $316.74 | $791.25 | |
Molina
| Professional | $60.00 | $60.00 | $60.00 | |
United
| Professional | $257.00 | $289.67 | $551.12 |