| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,500.00 | $7,655.00 | $13,151.00 | |
Aetna
| Professional | $3,600.00 | $3,600.00 | $7,655.00 | |
Cigna
| Facility | $27.04 | $36.07 | $80.73 | |
Medica
| Facility | $27.47 | $27.47 | $45.60 |