| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $707.95 | $707.95 | $707.95 | |
Aetna
| Professional | $707.95 | $707.95 | $707.95 | |
Anthem BCBS
| Professional | $60.26 | $72.44 | $72.44 | |
Cigna
| Facility | $64.57 | $64.57 | $64.57 | |
Molina
| Professional | $44.67 | $44.67 | $3,019.95 |