| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $146.62 | $146.62 | $592.79 | |
Aetna
| Professional | $101.41 | $146.62 | $146.62 | |
Cigna
| Facility | $151.97 | $151.97 | $151.97 | |
Cigna
| Professional | $151.97 | $151.97 | $151.97 | |
Medcost
| Facility | $146.62 | $161.28 | $197.94 | |
Molina
| Professional | $86.10 | $107.62 | $183.27 |