| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,801.89 | $3,801.89 | $3,801.89 | |
Aetna
| Professional | $3,801.89 | $3,801.89 | $3,801.89 | |
Cigna
| Facility | $64.57 | $64.57 | $64.57 | |
Cigna
| Professional | $1,905.46 | $1,905.46 | $1,905.46 |