| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,768.95 | $3,768.95 | $3,768.95 | |
Aetna
| Professional | $3,768.95 | $3,768.95 | $3,768.95 | |
Cigna
| Facility | $64.00 | $64.00 | $64.00 | |
Cigna
| Professional | $1,926.60 | $1,926.60 | $1,926.60 |