| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $748.07 | $776.12 | $10,137.66 | |
Aetna
| Professional | $748.07 | $776.12 | $794.83 | |
Cigna
| Facility | $794.83 | $794.83 | $794.83 | |
Cigna
| Professional | $794.83 | $794.83 | $794.83 | |
Wellpoint
| Professional | $749.27 | $749.27 | $749.27 |