| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,148.15 | $1,148.15 | $1,412.54 | |
CareSource
| Facility | $1,148.15 | $1,148.15 | $1,445.44 | |
Cigna
| Facility | $34.67 | $1,819.70 | $1,819.70 | |
Cigna
| Facility | AS | $181.97 | $181.97 | $181.97 |
United
| Facility | $758.58 | $758.58 | $758.58 |