| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $459.13 | $459.13 | $459.13 | |
Cigna
| Facility | $251.69 | $251.69 | $251.69 | |
Cigna
| Professional | $88.13 | $251.69 | $1,350.00 | |
Molina
| Professional | $375.40 | $662.00 | $1,049.51 | |
United
| Professional | $358.12 | $388.69 | $795.82 |