| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $204.26 | $204.26 | $204.26 | |
Cigna
| Facility | $283.73 | $283.73 | $423.43 | |
Cigna
| Professional | $47.85 | $283.73 | $705.00 | |
Molina
| Professional | $206.69 | $363.67 | $576.54 | |
United
| Professional | $204.26 | $303.48 | $453.92 |