| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $397.08 | $397.08 | $397.08 | |
Cigna
| Facility | $999.36 | $999.36 | $999.36 | |
Cigna
| Professional | $99.55 | $999.36 | $1,428.75 | |
Molina
| Professional | $60.00 | $60.00 | $60.00 | |
United
| Professional | $373.14 | $610.41 | $799.83 |