| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $19.22 | $699.72 | $2,811.89 | |
Aetna
| Professional | $19.22 | $19.94 | $20.43 | |
Cigna
| Facility | $19.76 | $20.43 | $20.43 | |
Cigna
| Professional | $20.43 | $20.43 | $20.43 | |
Wellpoint
| Professional | $19.09 | $19.09 | $19.09 |