| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $581.63 | $581.63 | $664.72 | |
Aetna
| Professional | $553.94 | $581.63 | $664.72 | |
Cigna
| Facility | $553.94 | $553.94 | $553.94 | |
Cigna
| Professional | $553.94 | $553.94 | $553.94 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 | |
United
| Professional | $259.32 | $553.94 | $720.12 |