| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,356.19 | $3,427.08 | $8,668.44 | |
Aetna
| Professional | $137.47 | $137.47 | $137.47 | |
Cigna
| Professional | $165.00 | $165.00 | $165.00 | |
Medcost
| Facility | $137.47 | $141.59 | $233.70 | |
Wellcare
| Facility | $100.00 | $100.00 | $100.00 | |
Wellcare
| Professional | $47.80 | $54.63 | $54.63 |