| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $403.89 | $836.47 | $3,070.90 | |
Aetna
| Professional | $836.47 | $836.47 | $1,032.19 | |
Cigna
| Professional | $360.74 | $360.74 | $360.74 | |
Molina
| Professional | $40.00 | $40.00 | $50.00 | |
Wellpoint
| Professional | $343.54 | $343.54 | $343.54 |