| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $645.65 | $954.99 | $3,019.95 | |
Cigna
| Facility | $1,584.89 | $1,584.89 | $1,584.89 | |
Cigna
| Facility | AS | $158.49 | $158.49 | $158.49 |
United
| Facility | $4,466.84 | $4,466.84 | $20,417.38 |