| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $15,821.91 | $26,580.80 | $27,385.59 | |
Aetna
| Professional | $14,126.71 | $15,821.91 | $15,821.91 | |
Cigna
| Professional | $16,087.50 | $16,087.50 | $16,087.50 | |
Medica
| Facility | $15,821.91 | $18,195.20 | $25,315.06 |