| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $380.19 | $380.19 | $1,698.24 | |
CareSource
| Facility | $398.11 | $398.11 | $501.19 | |
Cigna
| Facility | $34.67 | $645.65 | $645.65 | |
Cigna
| Facility | AS | $64.57 | $64.57 | $64.57 |
United
| Facility | $3,548.13 | $3,548.13 | $29,512.09 |