| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $100.00 | $700.30 | $12,690.90 | |
Cigna
| Facility | $265.22 | $5,257.46 | $5,441.47 | |
Cigna
| Facility | AS | $26.02 | $26.02 | $26.02 |
United
| Facility | $7,448.00 | $7,448.00 | $7,448.00 |