| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $134.90 | $134.90 | $1,698.24 | |
CareSource
| Facility | $141.25 | $141.25 | $177.83 | |
Cigna
| Facility | $34.67 | $229.09 | $229.09 | |
Cigna
| Facility | AS | $22.91 | $22.91 | $22.91 |
United
| Facility | $457.09 | $457.09 | $457.09 |