| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $785.65 | $785.65 | $785.65 | |
Aetna
| Professional | $475.00 | $785.65 | $2,100.00 | |
Cigna
| Facility | $132.22 | $192.15 | $471.70 | |
Cigna
| Professional | $1,252.00 | $1,252.00 | $1,252.00 |