| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $146.00 | $146.00 | $148.00 | |
Ambetter
| Facility | $107.00 | $107.00 | $3,342.18 | |
Cigna
| Facility | $238.00 | $238.00 | $238.00 | |
Medica
| Facility | $1,504.40 | $1,504.40 | $2,197.80 |