| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $771.39 | $771.39 | $771.39 | |
Cigna
| Facility | $213.28 | $1,414.26 | $1,414.26 | |
Cigna
| Professional | $199.14 | $1,414.26 | $3,266.25 | |
Molina
| Professional | $956.43 | $1,686.61 | $2,673.90 | |
United
| Professional | $1,194.83 | $1,194.83 | $1,874.92 |