| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $309.03 | $309.03 | $1,698.24 | |
CareSource
| Facility | $323.59 | $323.59 | $407.38 | |
Cigna
| Facility | $34.67 | $524.81 | $524.81 | |
Cigna
| Facility | AS | $52.48 | $52.48 | $52.48 |
United
| Facility | $3,548.13 | $3,548.13 | $29,512.09 |