| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $79.56 | $104.00 | $8,229.00 | |
CareSource
| Facility | $105.55 | $109.59 | $146.56 | |
Cigna
| Facility | $96.68 | $96.68 | $96.68 | |
Cigna
| Facility | AS | $9.47 | $9.47 | $9.47 |
United
| Facility | $50.00 | $668.00 | $3,176.00 |