| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $374.67 | $374.67 | $374.67 | |
Cigna
| Facility | $840.94 | $840.94 | $840.94 | |
Cigna
| Professional | $96.75 | $840.94 | $1,586.25 | |
Molina
| Professional | $60.00 | $60.00 | $60.00 | |
United
| Professional | $352.16 | $575.99 | $754.88 |