| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $794.33 | $794.33 | $794.33 | |
Aetna
| Professional | $794.33 | $794.33 | $933.25 | |
Cigna
| Professional | $269.15 | $269.15 | $269.15 | |
Medica
| Facility | $1,318.26 | $1,348.96 | $1,862.09 |