| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,312.00 | $1,312.00 | $1,806.00 | |
Ambetter
| Facility | $180.32 | $351.03 | $953.98 | |
Cigna
| Facility | $2,685.00 | $2,685.00 | $2,685.00 | |
Medica
| Facility | $1,341.74 | $2,575.15 | $3,831.67 |