| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $737.82 | $737.82 | $737.82 | |
Cigna
| Facility | $1,208.78 | $1,208.78 | $1,208.78 | |
Cigna
| Professional | $190.49 | $1,208.78 | $3,123.75 | |
Molina
| Professional | $914.91 | $1,613.39 | $2,557.82 | |
United
| Professional | $737.82 | $1,134.22 | $1,639.61 |