| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,085.84 | $1,085.84 | $1,085.84 | |
Aetna
| Professional | $318.22 | $1,270.80 | $6,277.99 | |
Cigna
| Professional | $673.84 | $673.84 | $673.84 | |
Medica
| Facility | $313.25 | $1,270.80 | $3,481.99 |