| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $585.03 | $913.76 | $1,600.00 | |
CareSource
| Facility | $635.52 | $707.64 | $770.99 | |
Cigna
| Facility | $680.75 | $680.75 | $680.75 | |
United
| Facility | $9,096.79 | $9,096.79 | $9,096.79 |