| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $731.16 | $1,145.06 | $2,375.69 | |
Aetna
| Professional | $963.77 | $1,145.06 | $1,145.06 | |
Cigna
| Facility | $64.00 | $64.00 | $64.00 | |
Cigna
| Professional | $520.86 | $520.86 | $520.86 | |
Medcost
| Facility | $1,145.06 | $1,145.06 | $1,603.08 | |
Wellcare
| Facility | $100.00 | $100.00 | $100.00 |