| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,374.87 | $16,890.41 | $28,790.97 | |
Aetna
| Professional | $2,374.87 | $2,374.87 | $2,374.87 | |
Anthem BCBS
| Professional | $96.98 | $112.57 | $114.10 | |
Cigna
| Facility | $64.00 | $64.00 | $64.00 |