| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $6,918.31 | $6,918.31 | $6,918.31 | |
Aetna
| Professional | $6,918.31 | $6,918.31 | $6,918.31 | |
Cigna
| Professional | $5,128.61 | $7,244.36 | $9,120.11 | |
Hally Health
| Professional | $100.00 | $199.53 | $199.53 | |
Molina
| Professional | $30.20 | $30.20 | $30.20 |