| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $511.16 | $511.16 | $511.16 | |
Cigna
| Facility | $654.00 | $654.75 | $654.75 | |
Cigna
| Professional | $44.35 | $654.75 | $674.39 | |
Molina
| Professional | $165.63 | $292.08 | $463.06 | |
United
| Professional | $381.67 | $448.08 | $843.63 |