| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $707.51 | $1,097.02 | $1,700.00 | |
CareSource
| Facility | $762.57 | $849.56 | $925.61 | |
Cigna
| Facility | $817.63 | $817.63 | $817.63 | |
Cigna
| Facility | AS | $81.31 | $81.31 | $81.31 |
United
| Facility | $2,910.00 | $2,910.00 | $2,910.00 |