| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $14.82 | $14.82 | $59,029.00 | |
Aetna
| Professional | $14.82 | $14.82 | $442.64 | |
Cigna
| Facility | $64.00 | $73.17 | $87.11 | |
Cigna
| Professional | $130.77 | $130.77 | $130.77 | |
Wellpoint
| Professional | $13.34 | $13.34 | $13.34 |