| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $5,128.61 | $5,128.61 | $5,128.61 | |
Aetna
| Professional | $5,128.61 | $5,128.61 | $5,128.61 | |
BCBS
| Professional | $489.78 | $489.78 | $812.83 | |
Cigna
| Facility | $64.57 | $64.57 | $64.57 |