| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,473.04 | $6,782.00 | $13,413.92 | |
Aetna
| Professional | $4,473.04 | $5,084.91 | $14,552.94 | |
Cigna
| Professional | $662.70 | $662.70 | $662.70 | |
Providence
| Professional | $662.70 | $662.70 | $2,400,000.00 |