| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $502.07 | $502.07 | $502.07 | |
Cigna
| Facility | $511.03 | $511.03 | $511.03 | |
Cigna
| Professional | $125.89 | $511.03 | $1,807.50 | |
Molina
| Professional | $60.00 | $60.00 | $60.00 | |
United
| Professional | $471.88 | $771.74 | $1,011.21 |