| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $588.84 | $588.84 | $870.96 | |
Aetna
| Professional | $575.44 | $602.56 | $724.44 | |
Cigna
| Facility | $616.60 | $616.60 | $616.60 | |
Cigna
| Professional | $616.60 | $616.60 | $616.60 | |
Molina
| Professional | $21.38 | $25.12 | $50.12 | |
United
| Professional | $125.89 | $616.60 | $724.44 |