| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $416.87 | $1,513.56 | $5,495.41 | |
Anthem BCBS
| Facility | $1,659.59 | $2,884.03 | $5,495.41 | |
CareSource
| Facility | $223.87 | $295.12 | $389.05 | |
Cigna
| Facility | $436.52 | $436.52 | $1,659.59 | |
Cigna
| Facility | 22 | $524.81 | $524.81 | $524.81 |
United
| Facility | $524.81 | $1,348.96 | $5,248.07 |