| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $676.08 | $676.08 | $1,412.54 | |
CareSource
| Facility | $724.44 | $724.44 | $891.25 | |
Cigna
| Facility | $1,174.90 | $1,174.90 | $1,318.26 | |
Cigna
| Facility | 54 | $812.83 | $812.83 | $812.83 |
United
| Facility | $457.09 | $457.09 | $4,466.84 |