| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $425.00 | $425.00 | $1,666.82 | |
Aetna
| Professional | $400.00 | $425.00 | $475.00 | |
Cigna
| Facility | $203.24 | $203.24 | $203.24 | |
Cigna
| Professional | $1,717.98 | $1,717.98 | $1,717.98 |