| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $318.75 | $318.75 | $750.00 | |
Aetna
| Professional | $266.10 | $400.00 | $400.00 | |
Cigna
| Facility | $240.15 | $488.10 | $1,519.49 | |
Cigna
| Professional | $1,317.63 | $1,317.63 | $1,317.63 |