| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $74.42 | $74.42 | $18,566.80 | |
Aetna
| Professional | $33.29 | $2,088.90 | $8,977.95 | |
Cigna
| Facility | $269.89 | $269.89 | $269.89 | |
Cigna
| Professional | $229.41 | $229.41 | $269.89 |