| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $957.85 | $1,508.21 | $20,333.70 | |
CareSource
| Facility | $1,052.95 | $1,168.00 | $1,272.55 | |
Cigna
| Facility | $1,133.06 | $1,133.06 | $1,133.06 | |
Cigna
| Facility | AS | $112.33 | $112.33 | $112.33 |
United
| Facility | $3,522.00 | $3,522.00 | $3,522.00 |