| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $707.95 | $707.95 | $1,348.96 | |
Cigna
| Facility | $645.65 | $645.65 | $645.65 | |
Cigna
| Professional | $1,288.25 | $1,288.25 | $1,548.82 | |
Medcost
| Facility | $707.95 | $794.33 | $1,479.11 | |
Molina
| Professional | $30.20 | $30.20 | $30.20 |