| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $85.83 | $9,062.00 | $22,776.00 | |
Cigna
| Facility | $96.68 | $96.68 | $890.00 | |
Cigna
| Facility | AS | $9.47 | $9.47 | $9.47 |
Medcost
| Facility | $78.30 | $94.72 | $161.13 | |
Medcost
| Facility | AS | $10.92 | $11.62 | $22.30 |
United
| Facility | $225.00 | $1,221.00 | $3,585.00 |