| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $746.60 | $751.56 | $1,054.47 | |
Aetna
| Professional | $751.56 | $751.56 | $751.56 | |
Cigna
| Facility | $64.00 | $64.00 | $64.00 | |
Cigna
| Professional | $477.77 | $477.77 | $477.77 | |
Medcost
| Facility | $751.56 | $751.56 | $1,052.18 | |
Wellcare
| Facility | $100.00 | $100.00 | $100.00 |