| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,615.08 | $2,683.70 | $3,134.90 | |
Aetna
| Professional | $318.22 | $318.22 | $2,160.00 | |
Cigna
| Facility | $64.00 | $64.00 | $64.00 | |
Cigna
| Professional | $673.84 | $673.84 | $673.84 |