| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $678.78 | $678.78 | $678.78 | |
Cigna
| Facility | $536.83 | $536.83 | $536.83 | |
Cigna
| Professional | $456.31 | $536.83 | $536.83 | |
Medcost
| Facility | $612.42 | $678.78 | $841.69 | |
Medcost
| Professional | $535.01 | $535.01 | $535.01 | |
Molina
| Professional | $30.00 | $30.00 | $70.00 |