| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $125.89 | $2,818.38 | $8,511.38 | |
Anthem BCBS
| Facility | $10,715.19 | $11,220.18 | $57,543.99 | |
CareSource
| Facility | $112.20 | $162.18 | $190.55 | |
Cigna
| Facility | $34.67 | $218.78 | $218.78 | |
Cigna
| Facility | AS | $21.88 | $21.88 | $21.88 |
United
| Facility | $602.56 | $4,466.84 | $30,199.52 |