| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $398.40 | $398.40 | $398.40 | |
Aetna
| Professional | $388.80 | $398.40 | $412.80 | |
Cigna
| Facility | $408.00 | $408.00 | $408.00 | |
Cigna
| Professional | $408.00 | $408.00 | $408.00 | |
Molina
| Professional | $30.00 | $45.00 | $60.00 | |
United
| Professional | $480.00 | $480.00 | $480.00 |