| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $144.54 | $144.54 | $1,412.54 | |
CareSource
| Facility | $147.91 | $147.91 | $186.21 | |
Cigna
| Facility | $34.67 | $239.88 | $239.88 | |
Cigna
| Facility | AS | $23.99 | $23.99 | $23.99 |
United
| Facility | $758.58 | $758.58 | $758.58 |