| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $260.01 | $260.01 | $312.01 | |
Aetna
| Professional | $260.01 | $260.01 | $260.01 | |
Cigna
| Facility | $9,641.19 | $23,988.41 | $30,862.87 | |
Medica
| Facility | $260.01 | $326.91 | $416.02 | |
Medica
| Professional | $364.01 | $364.01 | $758.00 |