| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $8,836.00 | $10,480.00 | $13,413.92 | |
Aetna
| Professional | $10,175.36 | $11,200.50 | $14,552.94 | |
Cigna
| Professional | $6,756.91 | $6,756.91 | $6,756.91 | |
Providence
| Professional | $6,756.91 | $6,756.91 | $6,756.91 |