| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $194.98 | $194.98 | $1,412.54 | |
CareSource
| Facility | $194.98 | $194.98 | $245.47 | |
Cigna
| Facility | $34.67 | $316.23 | $316.23 | |
Cigna
| Facility | AS | $31.62 | $31.62 | $31.62 |
United
| Facility | $758.58 | $758.58 | $758.58 |