| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $5,973.00 | $9,661.69 | $9,661.69 | |
Aetna
| Professional | $456.45 | $2,216.90 | $2,216.90 | |
Cigna
| Professional | $1,326.50 | $1,326.50 | $1,326.50 | |
MVP Health Care
| Professional | $1,326.50 | $1,326.50 | $1,326.50 |