| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,755.91 | $8,806.87 | $15,092.40 | |
Aetna
| Professional | $1,365.16 | $3,875.94 | $7,751.70 | |
Cigna
| Professional | $1,326.50 | $1,326.50 | $1,326.50 | |
Wellpoint
| Professional | $40.01 | $40.01 | $40.01 |