| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $499.73 | $499.73 | $499.73 | |
Aetna
| Professional | $499.73 | $499.73 | $499.73 | |
Cigna
| Facility | $552.13 | $552.13 | $552.13 | |
Cigna
| Professional | $59.71 | $552.13 | $866.25 | |
Molina
| Professional | $60.00 | $60.00 | $84.60 | |
United
| Professional | $469.67 | $512.29 | $1,006.64 |