| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $100.00 | $793.83 | $8,965.00 | |
Cigna
| Facility | $550.42 | $550.42 | $550.42 | |
Cigna
| Facility | 62 | $337.64 | $337.64 | $337.64 |
Cigna
| Facility | AS | $54.02 | $54.02 | $54.02 |
United
| Facility | $7,448.00 | $7,448.00 | $7,448.00 |