| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,609.26 | $1,609.27 | $23,857.60 | |
Aetna
| Professional | $1,609.27 | $1,609.27 | $1,609.27 | |
Anthem BCBS
| Professional | $0.02 | $0.02 | $0.02 | |
Cigna
| Facility | $64.00 | $64.00 | $64.00 |