| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $204.49 | $477.20 | $16,467.00 | |
Cigna
| Facility | $199.25 | $199.25 | $890.00 | |
Cigna
| Facility | AS | $19.50 | $19.50 | $19.50 |
Medcost
| Facility | $194.59 | $250.55 | $410.15 | |
Medcost
| Facility | AS | $30.96 | $37.94 | $58.57 |
United
| Facility | $1,471.00 | $5,871.00 | $8,973.00 |