| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $640.00 | $640.00 | $640.00 | |
Aetna
| Professional | $640.00 | $640.00 | $1,820.00 | |
BCBS
| Facility | $424.92 | $424.92 | $820.10 | |
BCBS
| Professional | $6.26 | $296.09 | $424.92 | |
Cigna
| Professional | $1,326.99 | $1,395.75 | $1,464.31 |