| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $22,628.38 | $22,628.38 | $22,628.38 | |
Aetna
| Professional | $50.90 | $50.90 | $50.90 | |
BCBS
| Professional | $84.62 | $84.62 | $84.62 | |
Cigna
| Facility | $4,480.00 | $4,480.00 | $4,480.00 |