| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $118.61 | $445.18 | $2,872.87 | |
Aetna
| Professional | $118.61 | $118.61 | $167.23 | |
Cigna
| Professional | $14.23 | $14.23 | $14.23 | |
Wellpoint
| Professional | $16.00 | $16.00 | $16.00 |