| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $160.60 | $2,113.00 | $10,268.00 | |
CareSource
| Facility | $136.38 | $163.66 | $202.58 | |
Cigna
| Facility | $21,571.00 | $21,571.00 | $21,571.00 | |
United
| Facility | $480.00 | $1,017.00 | $3,398.00 |