| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $676.08 | $676.08 | $676.08 | |
Aetna
| Professional | $676.08 | $676.08 | $676.08 | |
Cigna
| Facility | $537.03 | $537.03 | $537.03 | |
Cigna
| Professional | $457.09 | $537.03 | $707.95 | |
Hally Health
| Professional | $1,230.27 | $1,318.26 | $1,548.82 | |
Molina
| Professional | $30.20 | $30.20 | $30.20 |