| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $100.00 | $2,331.21 | $9,859.00 | |
Cigna
| Facility | $866.56 | $866.56 | $866.56 | |
Cigna
| Facility | 62 | $531.50 | $531.50 | $531.50 |
Cigna
| Facility | AS | $85.04 | $85.04 | $85.04 |
United
| Facility | $7,448.00 | $7,448.00 | $7,448.00 |