| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $437.85 | $437.85 | $437.85 | |
Aetna
| Professional | $437.85 | $437.85 | $437.85 | |
Cigna
| Facility | $546.85 | $546.85 | $546.85 | |
Cigna
| Professional | $81.44 | $739.60 | $1,471.88 | |
Molina
| Professional | $60.00 | $60.00 | $60.00 | |
United
| Professional | $51.01 | $58.87 | $686.88 |