| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $286.52 | $286.52 | $286.52 | |
Aetna
| Professional | $250.00 | $250.00 | $250.00 | |
Cigna
| Facility | $1,509.07 | $1,509.07 | $1,509.07 | |
Cigna
| Professional | $344.35 | $344.35 | $1,499.69 |