| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $5,470.60 | $5,470.60 | $5,470.60 | |
Cigna
| Facility | $7,100.47 | $7,100.47 | $7,100.47 | |
Cigna
| Professional | $6,035.40 | $7,100.47 | $7,100.47 | |
Molina
| Professional | $45.00 | $45.00 | $60.00 |