| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,908.26 | $1,908.26 | $1,908.26 | |
Aetna
| Professional | $1,908.26 | $1,908.26 | $2,323.42 | |
Cigna
| Facility | $4,300.60 | $4,300.60 | $4,300.60 | |
Cigna
| Professional | $4,300.60 | $4,300.60 | $4,300.60 |