| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $5,133.39 | $5,133.39 | $5,133.39 | |
Cigna
| Professional | $10,159.12 | $10,159.12 | $10,159.12 | |
Medcost
| Facility | $5,133.39 | $5,133.39 | $6,160.08 | |
Wellcare
| Facility | $80.00 | $100.00 | $100.00 |