| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $673.30 | $18,062.91 | $39,785.36 | |
Aetna
| Professional | $673.30 | $673.30 | $673.30 | |
Cigna
| Professional | $362.25 | $362.25 | $362.25 | |
Medica
| Facility | $673.30 | $14,057.78 | $18,711.00 |