| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,432.80 | $4,432.80 | $6,973.40 | |
Aetna
| Professional | $50.90 | $3,441.63 | $3,441.63 | |
Cigna
| Professional | $660.66 | $660.66 | $660.66 | |
Wellcare
| Facility | $100.00 | $100.00 | $100.00 |