| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $41,060.69 | $41,060.69 | $41,060.69 | |
Aetna
| Professional | $41,060.69 | $41,060.69 | $47,412.56 | |
Cigna
| Professional | $38,437.90 | $38,437.90 | $38,437.90 | |
Molina
| Professional | $30.00 | $30.00 | $3,900.00 |