| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $16.98 | $19.05 | $1,412.54 | |
CareSource
| Facility | $16.98 | $21.38 | $26.30 | |
Cigna
| Facility | $26.92 | $26.92 | $34.67 | |
Cigna
| Facility | AS | $2.69 | $2.69 | $2.69 |
United
| Facility | $457.09 | $457.09 | $457.09 |