| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $260.31 | $260.31 | $260.31 | |
Cigna
| Facility | $226.63 | $226.63 | $226.63 | |
Cigna
| Professional | $192.64 | $192.64 | $226.63 | |
Molina
| Professional | $60.00 | $161.07 | $279.20 |