| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $103.52 | $264.66 | $317.08 | |
Medcost
| Facility | $100.00 | $105.07 | $360.00 | |
Medcost
| Professional | $81.00 | $103.00 | $534.54 | |
Molina
| Professional | $30.00 | $257.30 | $612.62 |