| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $466.42 | $466.42 | $466.42 | |
Aetna
| Professional | $466.42 | $466.42 | $466.42 | |
Cigna
| Facility | $375.49 | $1,271.79 | $1,548.65 | |
Medica
| Facility | $1,072.52 | $1,266.30 | $2,591.17 |