| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $1.00 | $262.50 | $1,829.27 | |
Cigna
| Professional | $99.89 | $99.89 | $228.57 | |
Medcost
| Facility | $133.00 | $133.00 | $133.00 | |
Medcost
| Professional | $125.00 | $125.00 | $125.00 | |
Molina
| Professional | $30.00 | $30.00 | $70.00 |