| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $327.43 | $327.43 | $388.91 | |
Cigna
| Facility | $64.00 | $64.00 | $64.00 | |
Cigna
| Professional | $310.31 | $310.31 | $310.31 | |
Medcost
| Facility | $327.43 | $356.90 | $556.63 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |