| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $234.48 | $404.13 | $448.97 | |
Cigna
| Professional | $104.51 | $104.51 | $104.51 | |
Medcost
| Facility | $404.13 | $404.13 | $537.49 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |