| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $318.75 | $318.75 | $750.00 | |
Aetna
| Professional | $318.75 | $400.00 | $418.35 | |
Cigna
| Facility | $64.00 | $463.00 | $2,397.36 | |
Cigna
| Professional | $1,231.94 | $1,231.94 | $1,231.94 |