| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $245.47 | $245.47 | $1,412.54 | |
CareSource
| Facility | $257.04 | $257.04 | $316.23 | |
Cigna
| Facility | $34.67 | $407.38 | $407.38 | |
Cigna
| Facility | 52 | $323.59 | $323.59 | $323.59 |
Cigna
| Facility | AS | $40.74 | $40.74 | $40.74 |
United
| Facility | $758.58 | $758.58 | $758.58 |