| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $827.75 | $8,705.66 | $11,297.93 | |
Aetna
| Professional | $402.32 | $402.32 | $4,972.50 | |
Cigna
| Professional | $1,054.93 | $1,054.93 | $1,054.93 | |
Medica
| Facility | $402.32 | $402.32 | $442.55 |