| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $59,029.00 | $59,029.00 | $59,029.00 | |
Aetna
| Professional | $59,029.00 | $59,029.00 | $59,029.00 | |
Cigna
| Facility | $36.86 | $36.86 | $64.00 | |
Wellpoint
| Professional | $13.34 | $13.34 | $13.34 |