| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,047.13 | $1,047.13 | $1,047.13 | |
Ambetter
| Facility | $12.88 | $50.12 | $154.88 | |
Cigna
| Facility | $602.56 | $602.56 | $602.56 | |
Molina
| Facility | $1,445.44 | $1,445.44 | $1,445.44 |