| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,103.00 | $1,103.00 | $1,103.00 | |
Ambetter
| Facility | $231.28 | $480.21 | $819.63 | |
AmeriHealth
| Facility | $1,809.90 | $1,809.90 | $2,171.69 | |
Cigna
| Facility | $185.30 | $239.80 | $296.00 |