| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $600.79 | $600.79 | $600.79 | |
Aetna
| Professional | $586.30 | $600.79 | $622.50 | |
Cigna
| Facility | $615.26 | $615.26 | $615.26 | |
Cigna
| Professional | $615.26 | $615.26 | $615.26 | |
Molina
| Professional | $30.00 | $45.00 | $60.00 | |
United
| Professional | $723.84 | $723.84 | $723.84 |