| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $616.60 | $616.60 | $1,698.24 | |
CareSource
| Facility | $660.69 | $660.69 | $812.83 | |
Cigna
| Facility | $1,071.52 | $1,071.52 | $1,862.09 | |
United
| Facility | $1,230.27 | $1,230.27 | $8,128.31 |