| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,769.00 | $4,947.47 | $9,149.60 | |
Aetna
| Professional | $337.94 | $402.32 | $517.42 | |
Cigna
| Professional | $1,054.93 | $1,054.93 | $1,054.93 | |
Wellpoint
| Professional | $40.01 | $40.01 | $40.01 |