| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $218.78 | $218.78 | $1,412.54 | |
CareSource
| Facility | $213.80 | $213.80 | $269.15 | |
Cigna
| Facility | $34.67 | $346.74 | $346.74 | |
Cigna
| Facility | 62 | $218.78 | $218.78 | $218.78 |
Cigna
| Facility | AS | $34.67 | $34.67 | $34.67 |
United
| Facility | $758.58 | $758.58 | $758.58 |