| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $516.61 | $1,837.40 | $2,861.18 | |
Aetna
| Professional | $507.78 | $507.78 | $744.10 | |
Cigna
| Facility | $64.00 | $64.00 | $64.00 | |
Cigna
| Professional | $489.34 | $489.34 | $489.34 | |
Medica
| Facility | $507.78 | $858.15 | $1,411.89 |