| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $318.22 | $318.22 | $3,268.76 | |
Cigna
| Facility | $64.00 | $64.00 | $64.00 | |
Cigna
| Professional | $673.84 | $673.84 | $673.84 | |
Wellpoint
| Professional | $60.64 | $60.64 | $60.64 |