| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $993.59 | $993.59 | $993.59 | |
Aetna
| Professional | $917.98 | $993.59 | $1,060.57 | |
Cigna
| Facility | $200.00 | $300.00 | $353.00 | |
Molina
| Professional | $40.00 | $40.00 | $50.00 | |
Wellpoint
| Professional | $78.26 | $78.26 | $78.26 |