| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $605.46 | $948.11 | $1,700.00 | |
CareSource
| Facility | $654.02 | $734.24 | $799.97 | |
Cigna
| Facility | $698.21 | $698.21 | $698.21 | |
Cigna
| Facility | AS | $69.23 | $69.23 | $69.23 |
United
| Facility | $1,225.00 | $1,225.00 | $1,225.00 |