| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $446.68 | $446.68 | $446.68 | |
Aetna
| Professional | $446.68 | $446.68 | $446.68 | |
Cigna
| Professional | $257.04 | $257.04 | $257.04 | |
Emblem Health
| Professional | $1,862.09 | $1,862.09 | $1,862.09 |