| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,507.00 | $5,389.00 | $12,154.00 | |
Aetna
| Professional | $2.67 | $2,507.00 | $5,560.00 | |
Cigna
| Professional | $4.20 | $4.20 | $4.20 | |
Medica
| Facility | $1.78 | $100.00 | $253.12 | |
Medica
| Professional | $454.89 | $454.89 | $454.89 |