| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $954.99 | $954.99 | $2,570.40 | |
CareSource
| Facility | $1,023.29 | $1,023.29 | $1,258.93 | |
Cigna
| Facility | $34.67 | $1,659.59 | $1,659.59 | |
Cigna
| Facility | AS | $165.96 | $165.96 | $165.96 |
United
| Facility | $3,548.13 | $3,548.13 | $35,481.34 |