| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $5,440.13 | $5,440.13 | $6,800.16 | |
Medcost
| Facility | $3,081.00 | $3,081.00 | $3,636.25 | |
Medcost
| Professional | $2,418.00 | $2,418.00 | $2,598.00 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |