| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $445.72 | $445.72 | $445.72 | |
Cigna
| Facility | $606.51 | $606.51 | $606.51 | |
Cigna
| Professional | $112.05 | $606.51 | $1,627.50 | |
Molina
| Professional | $476.33 | $839.98 | $1,331.68 | |
United
| Professional | $445.72 | $697.80 | $990.48 |