| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $7,874.59 | $7,874.59 | $10,569.00 | |
Cigna
| Facility | $7,100.47 | $7,100.47 | $7,100.47 | |
Cigna
| Professional | $7,100.47 | $7,100.47 | $7,100.47 | |
Medica
| Facility | $17,861.61 | $17,861.61 | $28,959.06 |