| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $199.53 | $3,019.95 | $10,000.00 | |
Aetna
| Professional | $5,128.61 | $5,128.61 | $5,128.61 | |
Cigna
| Professional | $3,467.37 | $3,467.37 | $3,467.37 | |
Medica
| Facility | $100.00 | $7,762.47 | $10,232.93 |