| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,918.01 | $9,370.95 | $15,430.70 | |
Aetna
| Professional | $3,859.17 | $3,918.01 | $10,076.21 | |
Cigna
| Professional | $1,326.50 | $1,326.50 | $1,326.50 | |
Medica
| Facility | $1,901.43 | $3,859.17 | $3,918.01 |