| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $75.00 | $831.17 | $966.45 | |
Aetna
| Professional | $75.00 | $75.00 | $75.00 | |
Cigna
| Facility | $303.44 | $437.64 | $715.67 | |
Well Sense
| Professional | $2,500.00 | $3,000.00 | $4,024.75 |