| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $575.44 | $575.44 | $1,584.89 | |
CareSource
| Facility | $630.96 | $630.96 | $758.58 | |
Cigna
| Facility | $1,000.00 | $1,000.00 | $1,659.59 | |
United
| Facility | $2,454.71 | $2,454.71 | $20,417.38 |