| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $6,820.00 | $9,774.00 | $14,552.94 | |
Aetna
| Professional | $2,236.00 | $13,413.92 | $14,772.57 | |
Cigna
| Professional | $9,937.73 | $9,937.73 | $9,937.73 | |
Providence
| Professional | $9,937.73 | $9,937.73 | $9,937.73 |