| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,930.99 | $5,738.46 | $14,037.75 | |
Aetna
| Professional | $3,785.51 | $5,160.84 | $16,190.11 | |
Cigna
| Professional | $3,467.91 | $3,467.91 | $3,467.91 | |
Lucent Health
| Facility | $100.00 | $100.00 | $100.00 |