| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $123.25 | $123.25 | $1,785.50 | |
Aetna
| Professional | $100.05 | $120.35 | $123.25 | |
Cigna
| Professional | $80.54 | $80.54 | $80.54 | |
Emblem Health
| Professional | $72.48 | $80.54 | $80.54 |