| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,060.57 | $1,060.57 | $1,060.57 | |
Aetna
| Professional | $1,060.57 | $1,060.57 | $1,060.57 | |
Cigna
| Facility | $1,020.00 | $1,020.00 | $1,020.00 | |
Medica
| Facility | $1,060.57 | $1,060.57 | $1,421.16 |