| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,044.50 | $3,044.50 | $3,044.50 | |
Aetna
| Professional | $5,160.84 | $5,160.84 | $5,160.84 | |
Cigna
| Professional | $3,467.91 | $3,467.91 | $3,467.91 | |
Medica
| Facility | $5,160.84 | $8,721.82 | $14,140.70 |