| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,400.00 | $1,834.66 | $3,044.56 | |
CareSource
| Facility | $2,067.46 | $2,357.78 | $2,568.85 | |
Cigna
| Facility | $2,219.06 | $2,219.06 | $2,219.06 | |
Cigna
| Facility | AS | $218.70 | $218.70 | $218.70 |
United
| Facility | $765.00 | $765.00 | $765.00 |